Hampshire NCS Community Grant Sign-Up Form 2024

Grow Your Ambition (Hampshire)

NCS Community Grant Experiences - Summer 2024
Sign me up for this free experience!
Join us this summer for an exciting programme that will make a difference to you and your community with a variety of fun and engaging activities.

Experience 1 (Employability): Plan and manage exciting projects in conjunction with local charities and organisations to impact on the local community.

Experience 2 (Social Action): Put your plans to the test by bringing your project to life as well as volunteering in your local community.

Each day runs from 10:00-17:00.

Please note that on Monday and Tuesday we will be based in Eastleigh at Pavilion on the Park

On Wednesday and Thursday, we will be putting our plans into action!
Please select ONE of the following from below to book your place:*

The Pavilion on the Park (29th, 30th, 31st July and 1st August)The Pavilion on the Park(5th, 6th, 7th & 8th August)The Pavilion on the Park (12th, 13th, 14th & 15th August)The Pavilion on the Park (19th, 20th & 21st, 22nd August)
We just need a few details from you:
Young Person's Full Name*

First NameLast Name
Young Person's Date of Birth*

DayMonthYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Young Person's Email Address*
example@example.com
Young Person's Mobile Number*
Please enter a valid phone number.
Parent/Guardian's Full Name*

First NameLast Name
If address is different to the Young Person's please complete your address here

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian's Email Address*
example@example.com
Parent/Guardian's Mobile Number*
Please enter a valid phone number.
Additional Emergency Contact Name*

First NameLast Name
Additional Emergency contact relationship to young person*
Additional Emergency contact mobile phone number*
How would you describe your gender?
If you prefer to self-describe, please detail here
What is your ethnic background?*

Asian British or Asian - BangladeshiAsian British or Asian - ChineseAsian British or Asian - PakistaniAsian British or Asian - IndianAsian British or Asian - any other Asian backgroundBlack or Black British - AfricanBlack or Black British - CaribbeanBlack or Black British - Any other Black backgroundMixed - White and black CaribbeanMixed - White and Black AfricanMixed - White and AsianMixed - Any other mixed/multiple ethnic backgroundWhite - English/Welsh/Scottish/Northern Irish/BritishWhite - IrishWhite - Gypsy or Irish TravellerWhite - Any other White backgroundAny other ethnic background - ArabAny other ethnic backgroundPrefer not to sayPrefer to self describe
What is your religion?*

No religionChristian (including Church of England)CatholicProtestant and all other Christian denominations)BuddhistHinduJewishMuslimSikhAny other religionPrefer not to say
Which of the following options best describes your sexual orientation?*
If 'Other' please describe
Have you received free school meals in the last 6 years?*

YesNoPrefer not to say
Do you have any physical or mental health conditions or illness lasting or expected to last 12 months or more?*

YesNo
If the answer to the above question is yes, do any of of your conditions or illnesses reduce your ability to carry out day to day activities?*

YesNo
If yes, please give further details below:
Do you consider yourself to have a special educational need?*

YesNoPrefer not to say
If yes, please give further details:
Do you have any of the below? Please tick all that apply*

AnxietyObsessive Compulsive Disorder (OCD)DepressionPanic AttacksOther mental health conditionNone
If "Other mental health condition" was selected, please give further details below:
Do you have an Education, Health and Care Plan (EHCP)?*

YesNoPrefer not to say
Are you 'Care experienced?' This includes at any point in your life*

YesNoPrefer not to say
Do you regularly provide unpaid care for a relative, friend or family member with an illness, disability, mental health problem or an addiction?*

YesNoPrefer not to say
Education, Employment & Training - Which one of the following best applies to you?*

I am at school, sixth form or enrolled on a course at collegeI am doing an apprenticeshipI am on a traineeship, Kickstart or other government approved employability or training programmeI am in paid employmentI have left education and actively seeking workI have left education but I am not actively seeking work (due to caring responsibilities or health reasons for example)Prefer not to sayOther
Is English your first language?*

YesNoPrefer not to say
In the event of illness or accident, do you consent to any necessary medical treatment which is deemed necessary?*

YesNo
Please confirm that you consider yourself fit and able to participate in the activities and workshops*

YesNo
How did you hear about this experience/activity?*
Data Protection
The young person's data will be shared with National Citizen Service Trust (NCST - the grant funder) and with three research organisations - Verian (previously Kantar Public), Basis Social and London Economics - who are conducting an evaluation of NCST

The evaluation of NCST aims to understand young people’s experience of engaging with the activities it funds and the impact they are having on participants’ lives, to improve the support offered to young people

NCST and the research organisations will use your data for analysis and reporting purposes only.

Further information about how NCST processes personal information, including international transfers and individual rights can be found in the following privacy policy.
NCST would also like to communicate relevant opportunities to you - do you consent for this?*

YesNo
Date

MonthDayYear
Date
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Grow Your Ambition (Hampshire)

Sign me up for this free experience!

We just need a few details from you:

Data Protection