Accredited Mentoring Training APPLICATION FORM1

7/29/2019 Accredited Mentoring Training APPLICATION FORM1

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MENTORING YOUNG PEOPLE THAT ARE AT RISK OF ORINVOLVED IN GANGS AND VIOLENCELeading and promoting better practice

APPLICATION FORM

Name

Organisation (ifapplicable)

EmailTelephone numberAddress

Course qualifying questionsYes No

Have you had some experience of supporting a group orindividual to improve and develop?

This includes supervising staff or volunteers; providingadvice in a professional capacity; teaching and training;working with young people or adults to achieve specificoutcomes; coaching or similar types of activity.

If youre not sure if you qualify call Cheryl on 0121 2363609 to discuss.Are you available to attend both of the training days(Thursday 11 April 2013 and Tuesday 16th April 2013)

Page 1 of6Questions? Call Cheryl 0121 237 3609


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Do you have any additional learning requirements Yes No

If your answer is yes you can either tell us about it here orcontact us to discuss it. Call Cheryl on 0121 236 2609.

How did you hear about the course?


WHAT YOU CAN EXPECT FROM BRAP

Qualified and Professional tutors and staff

Breath of current knowledge that is both relevant and applicable to arange of contexts

Clear programme and criteria for assessment guidelines Support for your learning development and successful outcomes Responsiveness to any specific requirements the learner may have that

can reasonably be met

A non-threatening environment in which you are listened to inconfidence, shown respect, supported and encouraged

We are committed to the responsibilities listed above

WHAT BRAP EXPECTS FROM THE INDIVIDUAL LEARNER

Commitment to meet the programme requirements

Commitment to attend, be punctual and fully participate Commitment to complete and evidence all activities towards the

qualification i.e. private study, reflection and analysis, homework

Adherence to confidentiality guidelines

Adherence to Group Agreement

I understand and agree to the responsibilities listed above:

Signed Date.

We do not require you to sign this form before booking, but will ask you to sign a

hard copy, printed by us, on the first day of the course.


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Equality & Diversity Monitoring (CONFIDENTIAL)

Please fill in and return the following monitoring sheet along withyour application form. This information will be used solely to helpus monitor our Equal Opportunities in Employment policy and willnot be used for any other purpose.

To help us monitor our Equal Opportunities policy, please tick orcomplete the following boxes as appropriate.

Ethnic origin

Choose one section from (A) to (E) then tick the appropriate box toindicate your cultural background. These are based on the 2001 Censuswith additional categories included.

(A) White or White British

British Roma Polish

Irish Bosnian Albanian/Kosovan

Any other White background,please write here:

(B) Mixed

White and Black Caribbean White and Asian

White and Black African

Asian and Black

Any other Mixed background,please write here:

(C) Asian or Asian British



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Indian Kashmiri

Pakistani Bangladeshi

Any other Asian background,please write in:

(D) Black or Black British

Caribbean African

Any other Black background,please write here:

(E) Chinese / Chinese British or other ethnic group

Chinese Arab Afghan

Kurdish Vietnamese

Any other ethnic group, pleasewrite in here:

Gender

I am: female male transgender

Date of Birth: _______ Age: ________

Disability



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The Disability Discrimination Act 1995 defines a person as having adisability if he/she has a physical or mental impairment which has asubstantial and long term adverse effect on his/her ability to carry outnormal day to day activities.

Do you have a disability as defined above?

Yes No

If all of the above does not apply to you but you consider yourself to havea disability, please tick here:

What disability do you have? ______________________________________

Employment status

Are you currently

employed? unemployed?

Religion or Belief

Christianity Judaism

Buddhism Islam

Sikhism Hinduism

None

Other (please specify)

___________________________________

Sexual Orientation



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Heterosexual Prefer not to say

Gay Lesbian


You can email this form back to:

[email protected]

or post to brap:

2nd Floor, Lockside, 5 Scotland Street, Birmingham, B12RR
mailto:[email protected]:[email protected]

Accredited Mentoring Training APPLICATION FORM1

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