Creative Careers Academy Questionnaire

Full Name *

Nationality *

Do you have the right to work in the UK *

YES

NO

Date of birth *

Year

Month

Day

Your exact age on 01 June 2018 *

Are you currently in full or part time education? If yes when does this finish? *

Are you free to start employment from 04 June 2018? If NO, how much notice is required by your current employer? *

Any caring responsibilities, if so who? *

Any dietary requirements / allergies we need to be aware of? *

Ethnicity *

Any other Ethnic Group (please specify)

Do you consider yourself to be disabled under the Equality Act 2010? The Equality Act 2010 defines a person to be disabled if: they have a physical or mental impairment, the impairment has a substantial and long-term adverse effect on their ability to perform normal day-to-day activities. *

Yes

No

Prefer not to say

If so please indicate.

Cognitive or learning disabilities

Physical disabilities

Hearing impairment

Visual impairment

Invisible disabilities

Mental health condition

Other long term/chronic conditions

Any members of the household receiving income support benefits? *

Yes

No

Don't know

Prefer not to say

Any special arrangements / access requirements to be made on interview day? If so what are these?