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It gathers information about qualifications, disability or health needs and requested support, care-leaver status, and prior work experience. The form also captures goals, aspirations, preferred work areas, travel arrangements for SORM and placements, and consent for viewing Adult Social Care records. 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\"mailto:pfa@bradford.gov.uk\" \u0014pfa@bradford.gov.uk\u0015 Name of person completing this form:\u000b………………………………………………………………\nContact details (if different from applicant):\u000b………………………………………………………………\nSource of referral: \u000b☐ Self-referral/Networking\u000b☐ Family / Carer / Friend\u000b☐ Social Worker\u000b☐ School\n☐ College\n☐ Pre-Internship/Internship\n☐ Skills House\n☐ Internal (SORM)\u000b☐ Other (please specify):\u000b………………………………………………………………\u000b………………………………………………………………\nAbout You (the Applicant)\nFirst name: _____________________________________\u000bSurname: _______________________________________\u000bName you prefer to be called: ______________________\nDate of birth: ____ / ____ / ______\u000bEthnicity: ________________________________________\u000bLanguage spoken at home: _________________________\u000bPreferred method of communication: ________________\nEmergency contact name: __________________________\u000bTheir relationship to you: __________________________\u000bTheir contact details: ___________________________________\nYour Education\nDo you have an EHCP (Education, Health and Care Plan)?\u000b☐ Yes   ☐ No\nSchool or college you go to or your last place of Education:\u000b………………………………………………………………\nHave you previously completed an employability related course?\n☐ Yes   ☐ No\nIf yes, please specify:\u000b………………………………………………………………\u000b………………………………………………………………\nQualifications you are working towards or already have:\u000b☐ Entry Level\u000b☐ Functional Skills English\n☐ Functional Skills Maths\n☐ GCSE English\n☐ GCSE Maths\n☐ Other (please list):\u000b………………………………………………………………\nWhen did you achieve these?\u000b………………………………………………………………\nSupport Needs\nDo you have a disability or health condition?\u000b☐ Yes   ☐ No\nIf yes:\nHow has it affected your education, learning, or work?\u000b…………………………………………………………………………………………………\nWhat support would you like?\u000b…………………………………………………………………………………………………..\nDo you have a support worker or have you had one in the past? \u000b☐ Yes   ☐ No\nIf you currently have one, please provide their name and contact details:\u000b………………………………………………………………………………………\nAre you a care leaver?\nThis question helps us offer the right support and opportunities.\nYes       ☐            No     ☐           Prefer not to say   ☐\nWork Experience & Skills\nHave you had any work experience, placements, or volunteering?\u000b☐ Yes   ☐ No\nIf yes, where?\u000b………………………………………………………………………………………………..\nWhat did you enjoy about it?\u000b…………………………………………………………………………………………………\nDid you find anything difficult?\u000b…………………………………………………………………………………………………\nTell us about your skills and strengths:\u000b(e.g. communication, teamwork, problem-solving)\u000b……………………………………………………………………………………………………………………………………………………………………………………………………..\nYour Goals & Aspirations\nWhat do you hope to achieve from this programme?\u000b☐ Improve confidence\u000b☐ Get a paid job\u000b☐ Learn new skills\u000b☐ Meet new people\u000b☐ Become more independent\u000b☐ Other: ______________________________\nWhat are your dreams and aspirations?\u000b(For example: dream job, future goals, lifestyle)\u000b……………………………………………………………………………………………………………………………………………………………………………………………………..\nWhat kind of work would you like to try?\u000b☐ Retail\u000b☐ Admin\u000b☐ Catering\u000b☐ IT / Digital\u000b☐ Warehouse / Construction\u000b☐ Gardening\u000b☐ Health and Social Care\u000b☐ Cooking / Café\u000b☐ Other: ____________________________Travel\nHow will you travel to SORM and your work placement?\u000b………………………………………………………………\nDo you need help with travel or travel training?\u000b☐ Yes   ☐ No\nPermission\nAs part of the application process, we may need to view your Adult Social Care records to make sure your support needs are fully considered.\nDo you give permission for this?\u000b☐ Yes   ☐ No   ☐ Not sure – we can discuss this with you\nIf required, do you consent for SORM to contact a parent/carer to verify any details:\n☐ Yes   ☐ No\nReference\nPlease give us the details of someone (like a teacher, tutor or employer) who can tell us more about you.\nName: _____________________________________\u000bPhone number: ______________________________\u000b","cbCaia0SOVmg0vCd","https://ap.wps.com/l/cbCaia0SOVmg0vCd","docx",337219,"English","# Name of person completing this form\n## Contact details and referral source\n# About You (the Applicant)\n## Education\n## Support Needs\n# Work Experience & Skills\n# Your Goals & Aspirations\n## Permission\n# Reference\n# What to Do Next","[{\"question\":\"What information does the form collect about the applicant?\",\"answer\":\"It collects personal details such as name, date of birth, preferred communication method, education, and language spoken at home, plus emergency contact information.\"},{\"question\":\"How does the form address support needs and disabilities?\",\"answer\":\"Applicants indicate whether they have a disability or health condition, explain 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