Registration Form
NB: Before completing the form please ensure the following:
If you are already registered with a service provider, (examples below) please speak to your advisor to refer you to the opportunities with the London Designer Outlet.
Service providers can include:
- Job Centre Plus
- Work Programme Providers (CDG, Ingeus, Reed in Partnership, Urban Futures)
- BACES
- The College of North West London
- Or other voluntary and community organisations and groups
Project Name:London Designer Outlet / Registration Date:
Client Title: (eg Mr, Miss, Ms, Mrs, Dr) / Referral Organisation/ Self Referral
AdvisorName:
Client Name: / Vacancy / Course applying for:
ClientAddress:
Postcode: / Email:
Telephone:
Mobile:
Date of Birth: / Gender:
National Insurance Number:
Ethnic Origin: (Please Circle)
Black African / Black Caribbean / Black / Black British / Other / Indian / Pakistani / Bangladeshi / Chinese
Other Asian / White UK / White Irish / White Other /Other / White & Black African / White & Black/ Caribbean / White & Asian / Other Mixed / Other / Rather Not Say
Do you consider yourself to have a disability or a condition that affects your ability to do normal
daily activities?
If yes, please provide details:
Are you impacted by the Overall Benefit Cap?
Yes No
Are you claiming any of the following benefits?
Job Seekers Allowance / Disability Living
Allowance (DLA or PIP) / Incapacity Benefit/
Employment Support Allowance
Housing Benefit / Income Support / None
Are you currently unemployed?
Yes No / How long have you been unemployed?
Please Specify:
Please state what type of roles are you interested in applying for: (please circle as appropriate)
Retail all associated roles Admin Roles Coffee shop / Barista
Management positions Child Care Cinema positions
Security Reception Warehouse roles
Cleaning Catering Roles Service / front of house / kitchen
Restaurant all associated roles General Customers Service Other – please specify
Consent
I agree that, to the best of my knowledge, the personal details from this form are accurate and complete
and will be processed by Brent Council, under the principles of the Data Protection Act 1998. Where
appropriate, Brent Council may provide my personal information to a third party (e.g. employer or partner
organisation) to support my search for, and commencement of sustained employment.
Client Signature…………………………………………… Date……………………………
Print Name…………………………………………………. Date……………………………
Thank you for taking the time to complete the Registration Form