Residential & Training Opportunities Application Form

Personal Details

Title: —Please choose an option—MissMrMrsMsOther
Forname(s):
Last Name:
Date of Birth:
Address Line 1:
Address Line 2:
Town:
County:
Postcode:
Phone:
Email:
Preferred Contact Method: PhoneEmailPost

Equal Opportunity

In order that the Company can monitor its Equal Opportunities Policy, applicants are requested to complete this monitoring section. The information will remain confidential to the HR Department. It will not be made available to the interview panel.

Country of Residence:
Date of Entry to Country of Residence:
How would you describe your ethnic origin? —Please choose an option—ArabAsian - BangladeshiAsian - ChineseAsian - IndianAsian - OtherAsian - PakistaniBlack - AfricanBlack - CaribbeanBlack - OtherMixed - OtherMixed - White & AsianMixed - White & Black AfricanMixed - White & Black CaribbeanWhite - BritishWhite - GypsyWhite - IrishWhite - Irish TravellerWhite - OtherAny other ethnic groupPrefer not to say

Service Number

Please complete 1 of the following:

Military Service Number:
Veteran Service Number:
Parents Service Number:
Military force you or your parents were in: —Please choose an option—ArmyNavyRAFMarinesSpecial ForcesOther - please fill out below
Other:

Service Status:

How did you leave the military? —Please choose an option—Normal Service LeaverMedical DischargeWIS (Wounded, Injured, Sick) serviceAdmin DischargeEarly Service LeaverOther - please fill out below
Other:
Year of Discharge:

Skills/Expertise:

Course Dates

Please pick your prefered course date for the three day residential course: —Please choose an option—England - 8th November 2021Scotland - No Dates Available

Careers Information

Present Occupation (if applicable):
Career Intention:

Do you possess a full current driving licence: —Please choose an option—YesNo
Please state the category of driving licence held and the date of pass for each category:
Give details of any current endorsements:

Your Support Needs

DISABILITIES/LEARNING DIFFICULTIES

We wish to make our courses accessible to all verterans and veteran family members that wish to apply, the following information will help us to give you all the support you need. You will have the opportunity to discuss your needs during the interview.

Do you consider yourself to have a:Combat PTSDModerate Learning DifficultySevere Learning DifficultyDyslexiaDyscalculiaOther Learning DifficultyAutism Spectrum DisorderMultiple Learning DifficultiesVisual ImpairmentHearing ImpairmentDisability Affecting MobilityOther Physical DisabilityOther Medical ConditionEmotional/Behavioural DifficultiesMental Health ConditionTemporary Disability After Illness or AccidentProfound/Complex DisabilitiesAspergers SyndromeMultiple disabilitiesNo Learning DifficultyNo DisabilityAny Other

If Under 19 years of age

Present or Last School/College:
Date of Leaving:

Parent/Guardian/Carer Information

Name:
Address:
Phone:
Email:

Have you ever been convicted of a criminal offence? —Please choose an option—YesNo

(Declaration subject to the Rehabilitation of Offenders Act 1974)

Please give details:

How did you hear about the Attention to Logistics Programme?

I confirm that this application is, to the best of my knowledge, true and complete.

I understand and accept that any false statement may be sufficient for rejection or, if employed, dismissal.

Application forms are held on file for 9 months, please tick the boxes to let us know if you do or do not wish us to keep your details on file for 9 months YesNo
Full Name:
Date:
If you do not want to receive information from Tilbury on the Thames Trust that isn't related to this application, please tick the box