Access Interns Programme Application Form

Access Interns Programme Application Form

Apply for the Access Interns Programme, delivered by Variety, the Children’s Charity. Open to young people aged 16–19 with disabilities, the programme helps you build confidence, develop transferable skills and gain valuable experience for your future career.
Before you begin:
• You should be in Year 12 or 13 (or equivalent at college).
• You must be able to commit to the full internship period.
• If you are under 18, you must have permission from your parent/carer or guiding.

Guidance: This form takes around 15–20 minutes to complete. Please answer honestly and thoughtfully. If you have any questions or need support, contact interns@variety.org.uk.
Personal Details

Please complete all fields below.
Full name

First NameLast Name
Preferred name
Date of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
National Insurance Number
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Postcode
Mobile
Please enter a valid phone number.Format: 07000 000000.
Email address
example@example.com
Do you have the right to work in the UK?
© Variety, The Children’s Charity. For more information, visit www.variety.org.uk.

Next of Kin

Please provide the details of your next of kin. This person may be contacted in cause of an emergency during your internship.
Full name

First NameLast Name
Relation to you
e.g. parent/ grandparent/ carer
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone number
Please enter a valid phone number.Format: 07000 000000.
Email
example@example.com

Education

Please provide details of your current or most recent education, including school, sixth form or college. This helps us understand your academic abilities and how we can best support your career.
School/ College Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Person for Reference

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Position
e.g. teacher/ mentor
All predicted A-level / B-tech subjects and grades
List your A-levels, BTECs, or other qualifications
Achieved GCSEs subjects and grades (incl. Maths, Science & English)

Parental Consent - For candidates under 18

As the parent, legal guardian of the named candidate, I consent to them taking part in Corporate Internship facilitated by Access Interns. I have advised on any medication, disability, learning difficulties, or other vulnerabilities the candidate has that may impact their ability to carry out certain duties and/or affect their health and safety. I confirm that if the candidate leaves the employer’s premisses during lunch break periods, no liability can be accepted by the employer or Access Interns for any incident that may occur. I accept that Access Interns, Variety, the Children’s Charity, and the Kartik Foundation hold no liability or reasonability in the facilitating and duration of the Corporate Internship. I acknowledge that any reasonable adjustments required by the candidate are solely the employer’s reasonability, and that Access Interns, Variety, the Children’s Charity, and the Kartik Foundation bear no liability for any consequences, incidents, or issues arising from these adjustments.
Signature

CV/Resume (Optional)

Please upload your most recent CV/Resume, if available in PDF or Word format.
Current CV

Cancelof

Criminal Record Declaration
Do you have any unspent criminal convictions? Some placements may require a satisfactory background check. Having a criminal record will not necessarily prevent you from being considered, but may affect eligibility for certain roles.
If yes, please provide details
Should be Empty:

Next of Kin