Enterprising Young Leaders

Please complete the following form to book your place on this programme starting July 2018.

Everything you tell us is confidential and is only collected for administration, funder reporting and to make sure you get the best experience from your programme.



Your Details
Title
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Name(*)
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Surname(*)
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Gender
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Date of Birth
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Ethnic Origin
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Address
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Postcode(*)
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Email(*)
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Telephone(*)
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Emergency Contact - Name(*)
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Emergency Contact - Phone Number(*)
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Emergency Contact - Relationship to you(*)
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Additional Requirements
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For example, materials to aid dyslexia or partial sight, dietary needs, study support, wheelchair access



Additional Details
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Pre-Programme Questions
How would you rate your understanding of the programme's subject?
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What do you hope to gain from attending this programme?(*)
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What impact do you hope this will have on your organisation?(*)
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