MPT

To be eligible for support through More Positive Together we need to check that you have the legal right to live and work in the UK. Tick one box to confirm the item of evidence you are providing:

Full passport (EU member) Full passport (non EU member) UK Driving License Other

Please record the passport, birth/marriage certificate or residency card number:

Passport/residency card expiry date: (N/A for birth/marriage certificates)

Are you in paid work of any kind?

Yes - Full time work Yes - Zero hour contract No

In months, how long have you been out of work?

Has Covid-19 affected your employment in any way?

Yes No

If yes, how has Covid-19 affected your employment?

Are you currently looking for work/required to look for work?

Are you currently in education or training?

Yes- Full Time Education Yes - Part Time Education/Training No

Are you claiming any benefits?

Yes No

If yes, which benefits?

If other, please state

Ethnicity

Do you identify yourslef as being Cornish?

Yes No

Select one option below for the highest level of education or qualification you currently hold:

Below primary education (below isced level 1) Primary education or equivalent (isced1) Lower secondary education or equivalent (isced2) Upper secondary education or equivalent 9isced3) - GCSE Post-secondary (non-tertiary education or equivalent (isced4) - College Tertiary education or equivalent (isced 5-8) - University

Do you hold an Entry, Level 1 (Grade D/E) or Level 2 (Grade C) Qualifications in Maths?

Yes No

Do you hold an Entry, Level 1 (Grade D/E) or Level 2 (Grade C) Qualifications in English?

Yes No

Do you hold an Entry, Level 1 (Grade D/E) or Level 2 (Grade C) Qualifications in ESOL??

Yes No

Are you currently homeless or affected housing exclusion?

Yes No Prefer not to say

Do you currently live in a jobless household?

Yes No Prefer not to say

Do you live in a single adult household with dependent children (lone parent)?

Yes No Prefer not to say

Will you need childcare support/facilities if you embark on this project?

Yes No Prefer not to say

Are you an offender or ex-offender?

Yes No Prefer not to say

Do you consider yourself to have a limiting long-term health condition or disability?

Yes No Prefer not to say

Do you consider yourself to have a work limiting health condition?

Yes No Prefer not to say

Are you substance misuse dependent?

Participant Declaration (tick each box to confirm)

I know that the support I will be offered is funded by the European Social Fund. The information provided in the form is, to the best of myh knowldge, accurate. I am not in paid work of any kind, including any zero hours contract. If I have ticked a 'Participant chose not to say' option anywhere on this form, I confirm that I am refusing consent for this information to be collected. I give permission for my personal detils to be shared with the partners who are signatories to the Informaition Sharing Agreement involved in the delivery of this project. I understand that this information will be retained until at least 31 December 2033 for evaluation purposes. After that time, it will be destroyed in a secure manner. I may be contacted at any time to discuss my involvement in the project. I understand that the DWP, Government Internal Audit Agency, AQA, Statutory bodies and signatories to the information sharing agreement may request to see this information at any time and that it can only be shared in asecure manner and never emailed.

Useful Links

Legal Stuff

Ryan powell

head of operations