To Self Refer please complete and submit the form below.
Date
First Name*
Last Name*
Mobile Number*
Date of Birth*
Email Address*
Social Media Handle (optional)
Address (optional)
Please tick the services you are interested in:
CoachingHousing advocacyEmployment supportSelf employmentBusiness start/self employmentWellbeing
Please tick if you have the following:
CV (up to date)Disclosure letterSecure housingExperience of work (in your preferred sector)
Please give us an idea of the types of jobs you are interested in:
ConstructionLogistics - Driving rolesCleaning/facilities managementHospitalityRetailCreative industryAdministrationManagementOther Other Comments (optional)
I am:
18 years or overFree to work in the UK with a National insurance numberFree from any drug or alcohol reduction programme or medicationFree from convictions of sex offences, arson and terrorism
Please tick the relevant referral route:
Self-referralProbation referralDWPOther
Please confirm your consent:
I understand that my personal information will be treated in accordance with the General Data Protection Act 2018 and I give consent for the No Going Back Project to hold and use this information internally and externally for up to seven years, solely for the purposes of helping me to find suitable employment/training and also to provide the funders of this programme with the minimum information to meet funding requirements.
Name
