• Impart | Education

    Consent Forms
  • Format: 00000000.
  • Consent Form

  • I, * , acknowledge and understand that by signing this form, I agree to participate in intervention(s) under Impart's Education arm, and to the terms and conditions below.
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    1. Introduction
    Impart Education is overseen by Hajjah Nur 'Atikah (atikah@impart.sg). Our Youth Advocates (all of whom are volunteers) go through intensive training to ensure that we meet the relevant standards of care for the individuals who are under our care. Your participation in our programmes and services is entirely voluntary.

  • 2. Potential Risks and Benefits
    2.1 Potential Risks
    Impart Ltd. and the Youth Advocate will take all reasonable steps to provide a safe and conducive environment for each participant during the programme. However, Impart Ltd. assumes no responsibility whatsoever for any injury, loss, damage or harm to any participant or to his / her property, whether directly or indirectly, as a result of participation in the intervention(s), save as required by law. Impart Ltd. does not provide any medical, hospitalization or other insurance for participants in the intervention(s), nor will Impart Ltd. provide any medical treatment or compensation for any injury sustained as a result of participation in their interventions, except as required by law

    2.2 Potential Benefits
    Depending on our assessment of your needs and your goals, you may receive various interventions. You accept your responsibility to attend and participate fully all aspects of this programme, including:
    (a) Academic support: Receive academic support that is calibrated to your needs
    (b) Career development support: Explore the world of work and build meaningful relationships with mentors who can support you to discover meaningful careers.
    (c) Financial literacy support: Learn foundational financial literacy principles and practices.
    (d) Getting connected to other stakeholders and resources that may support you better in their specific needs  

  • 3. Confidentiality
    We agree that any information that is obtained for this programme that can be personally identified with you shall only be processed, used and disclosed for the purposes of fulfilling our obligations and providing the services mentioned in this letter; or with your prior written consent; or as required by law or an order of the court. A client file will be created for you during your journey with us. All information shared by you during the sessions is confidential and will not be revealed to any other person or agency without your permission with the following exceptions:

    3.1 Duty to Warn
    If you intend to take harmful, dangerous, or criminal action against another human being, or against yourself, Impart shall alert the appropriate individuals or agencies of such intentions. In addition, any actual or suspected acts of child, elder, or disabled person abuse (including physical abuse, sexual abuse, unlawful sexual intercourse, neglect, emotional and psychological abuse) will be reported to the appropriate agencies.

    3.2 Clinical Supervision / Consultations
    Information about you may be discussed in confidence, without revealing your identity, with other professionals and/or supervisors for the purpose of supervision and consultation, and providing you with suitable and tailored service.

    3.3 Resource Matching
    In the case where Impart connects you with an external resource, the following information will be released to the stakeholder either through their referral processes or through a password-protected document. Impart will get your consent for the provision of any additional information required.
    (a) Full Name, NRIC & Birth Date
    (b) Demographics (Gender, Race, Nationality)
    (c) Brief Background
    (d) Impart's Needs Assessment and Interventions

  • 4. Personal Data
    4.1 Personal data which we may collect from you or your child/ward includes, without limitation:
    (a) contact information such as their name, home or business address, email address and phone number;
    (b) information relating to their identity such as their birth date, nationality, and/or passport number or identity card details;
    (c) their resume, educational qualifications, professional qualifications and certifications, and employment references;
    (d) their work-related health issues and disabilities;
    (e) their responses to questionnaires administered within the programme; and
    (f) their photographs.

    4.2 The purpose of collecting such personal data:
    (a) for our legitimate business interests, including but not limited to the internal administration of our business, research studies, training and monitoring the performance of our staff and consolidating information and/or data, audit, compliance, documentation, IT security and risk management purposes, obtaining external advice on our obligations and rights etc.; and
    (b) to ensure our compliance with legal obligations that we are subject to, including but not limited to our obligations to the courts and to any other legal authorities, or to consultants and professional advisors such as accountants and auditors.

    There may be certain purposes / bases for collecting your data that are not specified above. If necessary, we will notify you of such other base or purpose at the time of obtaining your consent, unless the processing of your personal data without your consent is permitted under the PDPA or any other written law.

  • 5. Code of Conduct
    (a) The Youth Advocates(s) and the child/ward are not allowed to consume drugs/alcohol or smoke during their interactions or participation in the programme.
    (b) The Youth Advocate(s) and the child/ward are not allowed to partake in any illegal activities during their interactions or participation in the programme.
    (c) Lending and borrowing of money between Youth Advocate(s) and the child/ward are not permissible. The Youth Advocate(s), however, can connect the child/ward to resources or financial aid.
    (d) The Youth Advocate(s) is/are only allowed to meet the child/ward in public spaces and not any private spaces (including, but not limited to, a private residence or room or lodging in a hotel).      

  • 6. Participation and Withdrawal
    You can choose whether or not to allow your child/ward to be part of this program. You may withdraw their participation at any time without additional cost. Enrollment fees and Tuition fees are non refundable. (Only applicable to Labs)

  • 7. Learning Labs Payment
    (a) I consent to the payment of $75 for every 5 lessons of Impart's Learning Labs. This payment will cover the cost of tutoring support, programme materials, refreshments, and required meals.
    (b) I understand that payment for each block of 5 lessons is due before the commencement of the first lesson in that block.
    (c) I understand that failure to make payment before the commencement of lessons may result in the cancellation of lessons.
    (d) I agree to pay the above-stated fees via Bank transfer / PayNow.

  • Acknowledgement and Consent
    The purpose and nature of Impart Education's programmes and services have been sufficiently explained and I hereby provide my consent for my child / ward to participate in their intervention(s) and programmes. I fully understand, and agree to all terms and conditions listed above.

    I also provide consent to Impart Ltd. to use or disclose my personal data including, but not limited to [the full name, NRIC number, and contact details] for the purposes of providing the professional services and operations of the programmes and services.


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    Pick a Date*

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  • For child/ward under age of 21 (only if applicable):

    I,    ,       of    acknowledge and understand that by signing this form I agree to have my child to participate in interventions organised by Impart Ltd's Education arm subject to the terms and conditions above.

  • For child/ward under age of 21 (only if applicable):

    I,    ,             of    acknowledge and understand that by signing this form I agree to have my child to participate in interventions organised by Impart Ltd's Education arm subject to the terms and conditions above.

  • Absence of parent/guardian for child under age of 21 (only if applicable):

    Due to   ,     is unable to receive consent from parent/guardian. 

    ,    from  , who is involved in the case management of the child/ward, (1) is supportive of the referral made to Impart's Education arm, (2) is aware of Impart Education arm's scope of interventions, and (3) will be working closely with Impart to ensure the child/ward receives ethical and professional care according to the requisite standard of care.

  • For office use:
    Professional Indemnity
    I have discussed and explained all the terms stated in this consent form to the client to the best of my abilities. In my professional opinion, the client appears to understand the information I have presented. This person is fully competent to give informed consent to receive professional services offered by Impart's Education arm.

  • Involvement of Translator (only if applicable):
          

  • Overseen by:
    Hajjah Nur 'Atikah
    Head, Education 

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