Full Application Form

Please complete all of the questions to the best of your ability

This application form should be completed by the applicant (with support if necessary). Please give us as much detail as possible about your life situation and reasons for thinking Camelia Botnar is right for you.

Your Name(Required)

First Last

Date of Birth(Required)

Age

What is your biological sex?(Required)

What gender do you identify as?(Required)

Which department are you interested in?(Required)

Do you have a passport?(Required)

Do you have a driving license?(Required)

Your email address(Required)

Your mobile number(Required)

Do you know your national insurance number?(Required)

Please enter the national insurance number(Required)

Do you have a bank account?(Required)

Parent / Guardian Name(Required)

First Last

Relatiorship to you(Required)

Parent / Guardian email address(Required)

Parent / Guardian Address(Required)

Is this the address you will be using if a placement is agreed?(Required)

Please enter the address will you be staying at(Required)

Please tell us about your current living arrangements and who you live with(Required)

What schools or colleges have you attended?(Required)

What subject and grades did you achieve?(Required)

Employment history(Required)

Do you have any health problems?(Required)

Please give details of your health problems(Required)

Do you have any food or medical allergies?(Required)

Please give details of your food or medical allergies(Required)

Do you have a criminal record, or been involved with the police,(Required)

Please give details of your criminal record / ongoing investigations / bail conditions etc.(Required)

Do you have a social / support / family / youth justice worker?(Required)

Name of your worker(Required)

First Last

Contact number of your worker(Required)

Email address of your worker(Required)

Have you used drugs in the last 3 months?(Required)

Detail your last 3 months drug history(Required)

We are drug and alcohol-free charity and perform random testing. Do you understand and agree?(Required)

What are your life circumstances that make you think Camelia Botnar is right for you?(Required)

Explain how you think you fit the criteria of being disadvantaged or in a problematic situation(Required)

Is there any other information you would like to add to support your application?(Required)

CAPTCHA

Full Application Form

Please complete all of the questions to the best of your ability

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