REQUEST A PLACE ON NCS IN LEICESTER

REQUEST A PLACE ON NCS IN LEICESTER

This is for the daytime only programmes, not residentials.
Please complete the following details about yourself to request a place on the upcoming NCS Programmes.

Note: Filling in this form does not guarantee you a place, places are limited and our NCS team will email you within 2 working days of you requesting a place to let you know if there is availability on the programme.
Part 1: Your Personal Details
Please state your Full Name: *

First NameLast Name
Your Date of Birth:*

DayMonthYear
Please enter your date of birth: DD-MM-YYYY
Your Home Address*

Street Address

Street Address Line 2

CityCounty

Post Code
Your Email Address:*
Your Mobile Number:*
If you don't have a mobile number please just write in this box 'I don't have a mobile number'.
Home Phone Number (Optional)
What is the name of your current School/College or educational establishment?*
If you are home schooled please type in 'Home Schooled'.

Part 2: Your Parent/Guardian Contact Details

We will contact your parent/guardian for their permission for you to attend the NCS programmes and they will need to complete a medical form too.
Parent/Guardian Name: *

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What relation are they to you?*
Other, please state:
Contact Tel Number: *
Email Address: *
Emergency Contact Name - we will only contact this person in case of a medical or safeguarding emergency:*

Same as aboveOther
Other Emergency Contact Name: *

First NameLast Name
Email Address: *
Contact Tel Number: *
What relation are they to you?*

Part 5: Travel, Lunch and Collection Statement
Please Note:
- During the programme you, the participant, will be responsible for getting to and from the agreed venue and will be allowed to leave without parental collection at the end of the day.
- If your parents/guardians request that you only leave if collected by them, that you will adhere to this and stay on site until collected by your parent/guardian.
- You, the participant understand that NCS will NOT pay your transport costs to get to and from the NCS programme.
- During the programme, you may be required to undertake travel, either on foot, or by public transport, this will be paid for and supervised by NCS staff. For example we may visit a company or university campus as part of the sessions.
- You, the participant, understand that lunch is NOT provided by NCS and that you are required to bring your own lunch with you every day.
Please confirm you accept the Travel, Lunch and Collection statement*

YesNo
Part 6: Social Bond
We want everyone who takes part in the National Citizen Service (NCS) to enjoy the experience and take away new skills and memories. To ensure NCS is a positive experience for everyone you are required to comply with the Social Bond.

Please read through this document carefully.

We ask that you agree to:
1. Attend for the full duration of NCS - You are expected to fully participate and attend all NCS events for the full duration of the programme.
2. Behave responsibly and respect others - Show respect and consider the feelings and needs of others. Treat others as you would like to be treated yourself and do not behave inappropriately. Be respectful to the privacy of others when using social media and digital technology. Anyone who physically assaults a person or displays offensive and threatening behaviour will be removed from the programme and appropriate action will be taken.
3. Not bully other participants = Any form of bullying, discrimination or intimidation will not be tolerated.
4. Respect property - Do not damage buildings or their contents. If you do cause damage to property, you and your parents / guardians may be asked to contribute towards the repair or replacement. Criminal damage, theft and vandalism will be reported back to parents / guardians / carers and appropriate legal action will be taken.
5. Respect other possessions - You should respect other people's possessions and ensure that you keep your own possessions safe. Please do not bring valuable items with you.
6. Abide by smoking and vaping rules - strictly no smoking or vaping allowed on site at any time.
7. Not be in possession of weapons - You should not be in possession of any weapon during NCS events.
8. Abide by Health and Safety - You must listen and act on any Health and Safety instruction or requirement during all NCS activities. You must wear any appropriate safety equipment or protective clothing in the correct manner. You must take every step to always ensure your own safety and that of others at all times.
9. Listen and act on instructions from NCS staff and delivery partners - You must listen and act on any reasonable instruction given to you by a staff member.
10. Restrict use of your mobile phone - You should not use a mobile phone during activities (unless stated otherwise). Mobile phones should only be used during designated breaks / free times.
Part 7: Request Your Place
Please Note:

Places are limited and we will email you within 2 working days to let you know if you have a place or if we are full we will add you to the waiting list.
Please tick all these boxes once you have read and agreed to them:*

I confirm that I have read and understood the Social Bond above, and that I have answered all questions honestly and accurately.
Your Full Name*
Signature:*

Clear
If you are interested in finding out more about our Summer NCS Programme please let us know below. Please note this is NOT the Summer Residential:*

I would like to know more about the NCS Summer ProgrammeI do not want to know more about the NCS Summer Programme
Should be Empty:

REQUEST A PLACE ON NCS IN LEICESTER

Part 1: Your Personal Details

Part 2: Your Parent/Guardian Contact Details

Personal Data

Part 3: Further Information about you

Part 4: The Programme

Part 5: Travel, Lunch and Collection Statement

Part 6: Social Bond

Part 7: Request Your Place