Programme Interest Form
Please complete the form below, to the best of your knowledge. One of our expert navigators will contact you to discuss your interest. Belfast Works Connect has a strict eligibility criteria, we aim to support as many people within the community as possible, however, should we not be able to help, we will always aim to signpost to support organisations who can.
Name
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Phone Number
Which area of the Programme are you interested in:
What is your current status?
Unemployed (Sick)
Unemployed (Not Claiming Benefits)
Unemployed (Carer)
Unemployed (Jobseekers/Income Support)
Employed under 16 hours
Employed over 16 hours
Other
If other, please specify:
What is the best time to contact you:
Morning
Afternoon
Submit
Should be Empty: