Jumpstart Program – Expression of Interest Looking to leave school at the end of the year? Need a JUMPSTART in your skills for work? Register your interest for our JUMPSTART program in partnership with APM Employment Services! Referring Person DetailsThis is the information required about the person referring the young person to the program. In providing details in this form, you are giving consent for us to contact you and the young person to explore options and finalise registration into the program.Name(Required) First Last Email(Required) Enter Email Confirm Email Phone(Required)Who are you to the participant?(Required) Parent Teacher / School Contact Service Provider if you are a teacher / school contact / service provider, please provide name of organisation or school below Is the participant aware of your referral to the JUMPSTART program?(Required) Yes No Details/Reason for ReferralParticipant DetailsThis is the details of the young person wishing to participate in the Transition to Work "JUMPSTART" programName(Required) First Last Date of Birth(Required) DD slash MM slash YYYY Phone(Required)Email(Required) Currently enrolled in school?(Required) Yes No Current Year at SchoolPlease note; participants must be in year 10 or above to qualify for participation in this program Year 10 Year 11 Year 12 previously graduated school - under 25 years of age Leaving School?(Required)Are you currently looking to exit school and connect to an employment pathway including a possible traineeship or apprenticeship? Yes no Do you identify as any of the following:(Required) Aboriginal Torres Strait Islander No - I don't identify as either of these Consent(Required)I consent to my details being used for the purpose of communication between all parties relating to transition to work program participation with the noted Northern Sydney region providers and youth programs coordinated by Youth Up Front. Further details will be required to complete program enrolment including additional activity consent. Participants under the age of 18 require this consent to be provided by a responsible adult over the age of 18. These details should be reflected in the "Referring Person" details above. I consent to the above in relation to the submitted being used for the purposes listed above.CAPTCHA
