EET BURSARY APPLICATION

Page 1 of 3

During your time with Centrepoint, we will need to obtain/hold/process/share personal data and sensitive personal data about you which we would like to keep for 7 years when you leave our service (although we would like to keep a basic record of your time in our service until you reach age 35 – in case you need us to confirm this information).

In order to process your bursary application information, your data may be held outside of the EU/EEA.

Details of all your rights can also be found in our Privacy Notice for young people on our website at https://centrepoint.org.uk/privacy/young-people

Privacy Agreement

I understand that my personal data and sensitive personal data processed for the purposes of this bursary application may be held outside of the EU/EEA. I have read and understood the information above and I give my consent for Centrepoint to obtain and hold/use information of a personal and sensitive nature about me in accordance with Data Protection Regulations

NAME AND CONTACT INFORMATION

Full Name

Date of Birth

Contact Number

Email

Preferred Method of Contact

Are you currently supported by social services?

Are you a Refugee / Asylum Seeker?

ADDRESS AND KEYWORKER DETAILS

Are you currently being supported by a Centrepoint Service?

Centrepoint Service Name

What is Your Current Address

Most Recent Key Worker's Name

Most Recent Key Worker's Telephone Number

Name of Person Submitting the Application

Page 2 of 3

Please add each item you would like support with below. To add multiple items, click "Add another response" in the bottom right corner.

REQUESTED ITEM

Item Type

Description

Please state what the item is (e.g. Backpack for College)

Hyperlink

Please provide a link to where this item can be purchased

Item Cost

Please enter the cost of this item. You don't need to enter the £ sign

To add another item, please click "Add another response" in the bottom right corner of this box

REQUESTED ITEM

Item Type

Description

Please state what the item is (e.g. Backpack for College)

Hyperlink

Please provide a link to where this item can be purchased

Item Cost

Please enter the cost of this item. You don't need to enter the £ sign

To add another item, please click "Add another response" in the bottom right corner of this box

EET OPPORTUNITY DETAILS

Application to Support

Course Provider/Employer

Course Title/Job Role

Length of Course

Contract Type and Hours

Details of EET Opportunity

How will the Bursary Help You to Achieve Your Goals?

Page 3 of 3

ADDITIONAL INFORMATION

How has your time been at Centrepoint? Is there anything that stands out, for example programmes you have engaged with

What are your Long-Term Goals?

SUPPORTING DOCUMENTS

So that we can quickly process your application, please upload any documents that help to support this application. For example, this could be a learning agreement, letter of acceptance to a course or a job offer.

To add multiple documents, please click "Add another response" below

If supporting documents are not required please attach a blank document

Please Upload a Document