PICS Learner Management System : Applicant Sign Up : Internship Application Form

London Borough of Culture - Internship Application Form

Title: *

First Name: *

Preferred First Name:

Surname: *

First Line of Address: *

Town/City:

Postcode: *

Sex: *

Ethnicity: *

Mobile: *

E-mail address: *

Date of Birth: *

Have you achieved a minimum of 3 A'levels and/or are educated to Level 3 standard? *

We may contact you about course opportunities and learner events. Please provide contact methods allowed: *

Preferred Contact Method *

Are you care experienced?

Yes
No

Are you in education, employment or training?

Yes
No

Are you in receipt of jobseekers allowance?

Yes
No

Please provide a short profile about yourself: *

Tell us about your interest in arts and culture: *

How will this internship help you with your long-term goals? *

What qualities, skills or experiences make you a strong candidate for this internship? *

First Choice (please select one) *

Dance
Film
Theatre
Music
Community Art

2nd Choice (please select one) *

Dance
Film
Theatre
Music
Community Art

What language/s do you speak? *

Do you have any existing Medical/Mental Health Conditions that we should be aware of? *

Primary Disability/Learning Difficulty: *

Learning Difficulties and Disabilities (LLDDs)

If yes, please supply further information and details:

Do you have any special education needs that we should be made aware of?

Regarding question above, how best can we support you?

Date of application: *

Submit