Green Advantage Application Form

Green Advantage Application Form
Green Advantage is a sustainability short course from Aston University, funded by the West Midlands Combined Authority as part of the Government’s Skills Bootcamps.

If selected to participate in the programme, you will be required to provide evidence of improving the sustainability of your business activities. Places on the programme are limited.

If you have any queries, contact: centreforgrowth@aston.ac.uk or call 0121 204 3225

Please complete this form and submit to centreforgrowth@aston.ac.uk

1. APPLICATION DETAILS
Name*

First NameLast Name
Preferred Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number
Email
example@example.com
Date of Birth*

MonthDayYear
Date
National Insurance Number*
Gender

MaleFemalePrefer not to sayPrefer to self-define
Gender - self-define
Company name (if unemployed, skip to Question 2.)
When did you start working for the company? (Format: MM/YYYY i.e 06/2020)*
Have you been living in the UK for the past three years?

YesNo
2. BACKGROUND
Why would you like to take part in Green Advantage?*
How do you think the course would benefit you?*
If you are employed currently, how do you think your responsibilities in the workplace could develop as a result of completing the course? *
3. QUALIFICATIONS
Highest Previous Qualifications – please tick ONE box only:
Type a question*

GCSEs/BTEC (5 A*-C/9-4 or 2/3 AS Levels)A-Level/National DiplomaUndergraduate DegreeMaster’s DegreePhD/DoctorateOther, please state
Other:
If your qualifications are level 6 or above (Undergraduate, Master's, PhD/Doctorate or equivalent, please state which subject:*
4. EMPLOYMENT INFORMATION
What is your employment status? (please tick one)
Full-Time EmploymentPart-Time EmploymentEmployed – Zero-Hour ContractSelf-EmployedUnemployed Less Than 12 MonthsUnemployed More Than 12 MonthsNot Working – Long Term SicknessNot Working – Caring ResponsibilitiesPrisonerRetired
If employed, please fill out your employment details:
Name Of Employer:*
Workplace Postcode: *
Current Job Title: *
Industry / Sector of Current Occupation: *
Hours Worked Per Week (approx). *
Start date with employer

MonthDayYear
Date
Estimated current salary. Please provide the closest match. (if unemployed please state N/A)*

£0 - £10,000£15,000 - £20,000£21,000 - £28,000£30,000 - £40,000£42,000 - £50,000£50,000+N/A
Please indicate frequency of income:*

HourlyWeeklyMonthlyYearly
Do you currently receive any of the following assistance?
JSAEmployment and Support Allowance – Work Related Activity Group (ESA - WRAG)Universal CreditOther
If other, please state below
Do you plan to work alongside the bootcamp?*

Yes (Full-time employment)Yes (Self-employed)Yes (Part-time employed)No
Do you have any caring responsibilities for children or other adults?*

YesNo
5. MONITORING
The information requested is provided on a confidential basis and will not be used as part of the shortlisting process. It will only be revealed in aggregate form. The exception to this is in relation to Programme auditors who will be able to view all the Programme administration records.

Please indicate your ethnic group: please tick ONE box
White

British (including N.Ireland)IrishGypsy or Irish TravellerOther
Mixed/Multiple ethnic groups

White and Black CaribbeanWhite and Black AfricanWhite and AsianOther
Asian/Asian British

IndianBangladeshiPakistaniChineseOther
Black/African/Caribbean/Black British

AfricanCaribbeanOther
Other ethnic group

ArabOtherPrefer not to say
Do you consider that you have a learning difficulty, disability or long-term health condition?*

YesNoPrefer not to say
If you have answered yes to the previous question, please state which disability:
6. EMERGENCY CONTACT
Name

First NameLast Name
Phone Number
Relationship to you:
7. CONTACT AND MARKETING
How did you hear about us?
Your information may also be shared with other third parties for the above purposes, but only where the law allows it. The sharing of information follows data protection legislation. Would you like to be added to the Aston Centre for Growth's mailing list to receive information about future courses, learning opportunities and events?*

YesNo
Would you like to be added to the Aston Centre for Growth's mailing list to receive information for research and evaluation purposes?*

YesNo
Which of the following are your preferred method/s of being contacted?*

PostPhoneEmail
Should be Empty:

Green Advantage Application Form

1. APPLICATION DETAILS

2. BACKGROUND

3. QUALIFICATIONS

Highest Previous Qualifications – please tick ONE box only:

4. EMPLOYMENT INFORMATION

What is your employment status? (please tick one)

5. MONITORING

6. EMERGENCY CONTACT

7. CONTACT AND MARKETING