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Great Opportunities referral form

Client Details
Contact Details
Referring Agency/Organisation
Gender & Disability Details
Client Situation
Employment Categories of Interest
Please indicate what areas of work you would be interested in, for example: 'clerical work’, 'retail' or similar?
Self-Assessed Ethnicity
What Next and the Data Protection Act
Thank you for completing this form. Please read the paragraph below and, if you agree, please select the ‘Agree’ box. This will then mean that we can share relevant information with other organisations to assist you in finding work or training and we can start to support you.
I give my permission for the information I have given on this form to be shared with relevant organisations to assist me in accessing opportunities. I understand that the information I have given will be shared to help me find a job or training. The organisations may contact each other and me, to monitor the effectiveness of this referral process.
Details on this form are confidential and will not be used for any other purpose than that already stated.