Application Form Name * First Name Last Name Phone * Email * Date of birth * (Some of our programmes have age restrictions) MM DD YYYY Name of the programme that you are applying for Gender * Male Female Intersex Non-binary Prefer not to say Other (please state) How would you describe your ethnic origin? * White British White Gypsy/Irish Traveller White Irish White/White European Other White Background Mixed/Multiple ethnic groups Asian Bangladeshi Asian British Asian Chinese Asian Indian Asian Pakistani Other Asian Background Black African Black British Black Caribbean Black Other Other Black Background Middle/Near Eastern/Arab Any Other Ethnic Group Prefer not to say What London borough do you live in? * Barking and Dagenham Barnet Bexley Brent Bromley Camden Croydon Ealing Enfield Greenwich Hackney Hammersmith and Fulham Haringey Harrow Havering Hillingdon Hounslow Islington Kensington and Chelsea Kingston upon Thames Lambeth Lewisham Merton Newham Redbridge Richmond Upon Thames Southwark Sutton Tower Hamlets Waltham Forest Wandsworth Westminster Other (please state) If 'Other' please state What keeps you busy at the moment? * College University Training Internship Part-time work Full-time work None of the above Other (please state) Why are you applying for this programme and why do you think it is right for you? * Do you require any special support that we should know about? * If you are invited for an interview, when is the best time to contact you? * Monday (9.30am – 1.00pm) Monday (2.00 – 6.00pm) Tuesday (9.30am – 1.00pm) Tuesday (2.00 – 6.00pm) Wednesday (9.30am – 1.00pm) Wednesday (2.00 – 6.00pm) Thursday (9.30am – 1.00pm) Thursday (2.00 – 6.00pm) Friday (9.30am – 1.00pm) Friday (2.00 – 6.00pm) How did you hear about this programme? * Someone who was on a previous Damilola Taylor Trust programme (please state who) Recommended by someone I know Damilola Taylor Trust website Social media (Facebook, Twitter, Instagram) Email College/University Parent/Guardian Other (please state) If 'Other' please state Do you consent to Damilola Taylor Trust and their agents holding your data in order to contact you about your participation in this programme? * Yes No Do you consent to the Damilola Taylor Trust contacting you with news, events and information (including about other programmes) that may be of interest to you? * Yes No Please add any additional information that you would like to include with your application Thank you for your application.
