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Supported Internship Application Form

Supported Internship Application Form

Step 1 of 4

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Applicant Information
Name * REQUIRED
First Last
Address * REQUIRED
Street Address Address Line 2 City Post Code
Contact Number * REQUIRED
Email * REQUIRED
Date of Birth * REQUIRED

Day
Month
Year
How old will you be on 31 August 2022 * REQUIRED
Do you have an EHCP? * REQUIRED
- Yes
- No
Are you your own legal guardian? * REQUIRED
- Yes
- No
Parent / Guardian Information
Please give details of your legal guardian.
Name * REQUIRED
First Last
Address * REQUIRED
Street Address Address Line 2 City Post Code
Contact Number * REQUIRED
Email * REQUIRED
Do you want to add details of another Parent / Guardian / Carer?
- Yes
- No
Parent / Guardian 2 Information
Name * REQUIRED
First Last
Address * REQUIRED
Street Address Address Line 2 City Post Code
Contact Number * REQUIRED
Email * REQUIRED

Education and Work Information
What are you currently studying?
Please tell us about any previous work experience you have.
Workplace Name
Dates worked
Did you get paid?
Please give a brief description of your duties
Add another?
- Yes
- No
Workplace Name * REQUIRED
Dates worked * REQUIRED
Did you get paid? * REQUIRED
Please give a brief description of your duties * REQUIRED
Add another?
- Yes
- No
Workplace Name * REQUIRED
Dates worked * REQUIRED
Did you get paid? * REQUIRED
Please give a brief description of your duties * REQUIRED

The goal of the Supported Internship programme is for you to get a job where you work in an integrated setting. This means you work with people with and without disabilities.You will be paid the typical wage for the job. You will be expected to work at least 16 hours each week, with the goal to work full time.
Are you willing to work 16 or more hours a week in an integrated setting after you finish your Supported Internship? * REQUIRED
- Yes
- No
Where would you like to work after you finish your Supported Internship? * REQUIRED
Does your family / guardian / carer support your work goals? * REQUIRED
- Yes
- No
Do you have a preference on where you undertake your placement? * REQUIRED
- Broadgreen Hospital
- Liverpool City Council
- Any
Do you have the right to live and Work in the UK? * REQUIRED
Visit www.gov.uk/right-to-reside for more information.
- Yes
- No

Your Personal Statement
If this section is scribed, please write the exact words used by the applicant.
Why do you want to be a Supported Intern? * REQUIRED
What do you want us to know about you? * REQUIRED
How did you find out about the Supported Internship Programme? * REQUIRED
Consent * REQUIRED
We collect and process information to enable us to provide the service requested. GDPR requires Greenbank College obtain your agreement before this can be done. Any information you give will be processed under the rules and safeguards laid down by GDPR regulations. Greenbank has procedures in place to ensure that all information held about you will be dealt with confidentially, held securely and only processed in accordance with Greenbank’s notification to the Information Commissioner, who administers GDPR.
I agree with the storage and handling of my data by this website.
Subscribe to our mailing list
You will receive news, updates and event promotion emails to keep you up to date with what is going on at Greenbank College. You can change your mind at any time by clicking the change your preferences or unsubscribe links in the footer of any email you receive from us. We will treat your information with respect. For more information about our privacy practices please see our privacy policy.
- Yes, please subscribe me!
Comments
This field is for validation purposes and should be left unchanged.

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_{Greenbank Lane, Liverpool, Merseyside L17 1AG England · Tel: 0151 733 7255 · Registered Charity Number 513814 · Company Registered in England 1696490 · Greenbank College is part of Greenbank a long established Liverpool based registered charity which provides a range of services for disabled people and other disadvantaged groups.}

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