Health & Social Care Sign Up Form

Preferred First Name*

Last Name*

Which of the following pronoun do you use?*

She/ Her/ Hers/ Herself

He/ Him/ His/ Himself

They/ Them/ Theirs/ Themself

Ze/ Zir/ Zirs/ Zirself

If other, please specify here:

Email Address*

Mobile Phone*

Date of Birth (DD/MM/YYYY)*

I confirm that I am aged between 16-30.

Which County do you live in?

What is your postcode?*

What is your house/flat number?*

The following questions will help us tailor our support to meet your needs

If you are currently working, what is your job title?

If you are working, in education or volunteering, how many hours does this take up per week?

If you are not working, how long has it been since you last had a full time job?

Which course are you interested in (please select all that apply)*

Get into Health and Social care

Get Started with Health and Social Care

Get Started with Ambulance Assistance Practitioner

Get Started with Emergency call handler (111)

Having a mentor help me find a H&SC job

If other - please add here

How did you hear about this opportunity?

What support are you looking for from The Prince’s Trust (select all that apply)

Insight into the Health & Social care sector

Short work experience doing a Health & Social care job

CV writing support for applying for a Health & Social Care job

Interview preparation for a Health & Social Care job

A mentor to help support me to get a Health and Social Care job

Just want a Health & Social Care job

Something else (please tell us below)

Do you have a right to work in the UK?*

Yes

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Text Message

Phone

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By entering your details in to this form, you agree to us contacting you about this job role using the information you have provided. As part of signing up to The Prince’s Trust Health and Social Care course, you will be offered on-demand learning with Future Learn and Skills 2 Succeed Academy.

The information you provide will form a digital file that will be used to record progress of your enquiry as well as any activities that you may subsequently undertake with us.

Information we collect from you will be kept for a reasonable time as necessary to manage your enquiry and to meet any funder or statutory requirements should you subsequently engage on activities with us.

The information we collect from you helps us to run, fund and evaluate our effectiveness as an organisation.

For further details about how we use your information please see the full privacy statement available at www.princes-trust.org.uk. and search for ‘privacy policy’, alternatively please click the link at the bottom of this page.

Please confirm that you have read our Privacy Policy and consent to The Prince's Trust collecting this information:

I have read the Privacy Policy*

I consent to The Prince's Trust collecting this information*

Take the first step towards a career in Health & Social Care

The following questions will help us tailor our support to meet your needs