1. Firstname: *

 

2. Lastname: *

 

3. What is your preferred pronoun: *

 

4. Contact number (mobile): *

 

5. Email Address: *

 

6. Home address: *

 

7. Date of Birth *

   DD/MM/YYYY 
 
 

8. Ethnicity *

 

9. Please state any additional support you may require accessing the course or resources:

 

10. Please tell us a bit about yourself (e.g. what are your interests or hobbies, what job aspirations do you have, what inspires you?) and why you would like a place on the programme?

 

11. What do you think you would need most support with, please select up to 3: *

 

12. Do you have a preference for a mentor? *

 

13. By signing up to this mentoring programme, I understand that I will be matched to another individual, and I am open to meeting them in person and/or virtually *

 

14. I understand and consent that any personal information relating to me that I share in relation to the programme will be processed and used in accordance with the Moving Ahead and British Gymnastics Foundation privacy policies *

 

15. Application Date: *

   DD/MM/YYYY