Building Futures Programme Registration

Name*

First Last

Date of Birth (dd/mm/yyyy)*

Email*

Mobile Phone Number

Gender

Male
Female
Non-Binary or Gender-Nonconforming
Prefer not to say

Do you identify as someone with a diverse ethnic background?

Yes
No

Where are you based in the UK?

London inc Greater London
England North e.g. Manchester, Liverpool, Sheffield, Newcastle
England South e.g. Bristol, Kent, Essex, Cambridge
Midlands e.g. Birmingham, Coventry, Nottingham, Leicester
Northern Ireland
Wales
Scotland
Outside the UK

How did you hear about the Building Futures Programme?

Is your household income below £30,000 per year?

Yes
No
Prefer not to say

What is your employment status? Select from the following:

Full time
Part time
Student
Not in employment, education or training

If you are a student, what university do you attend?

If you are in employment, what is your job position?

Do you have any access requirements to make us aware of? Please provide details.

Do you have a My Blueprint for All account?

Yes
No

How did you hear about the Building Futures Programme?

Eventbrite
My Blueprint for All
Emails/Newsletters
Social Media/LinkedIn
Word of mouth e.g. friend, family, colleague, teacher
Other

Ethnic Origin - How would you describe your ethnic origin? Mixed/Multiple Ethnic

White and Black Caribbean
White and Black African
White and Asian
Any other mixed background

Asian/Asian British

Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background

Black/ African/ Caribbean/ Black British

African
Carribean
Any other Black/African/Carribean

White

English/ Welsh/ Scottish/ Northern Irish/ British
Irish
Gypsy or Irish Traveler
Any other white background

Other ethnic group

Arab

Any other ethnic group

Please state

Data Protection Act 1998

Blueprint for All processes data in accordance with the Data Protection Act 1998. The personal information that you provide on these forms will be processed for purposes connected to the legitimate business of Blueprint for All and may be transferred between Blueprint for All departments. Some of the information that you provide on this form may be sent to the Funding Councils, their agents and other statutory bodies for statistical and other purposes.

Declaration

I declare that the details given on this form are true to the best of my knowledge

Building Futures Programme Registration

Blueprint for All Building Futures Programme Registration Form

Building Futures Programme Registration Form