Expression of Interest Form
You are completing an expression of interest to work with Activating Creative Talent (ACT) CIC. This is not an agreement or a contract for work. We will keep all contact details and personal data secure and confidential at all times, which will only be accessed by our senior members of staff who have the relevant permission and authority to access and protect your personal data.

ACT CIC Privacy Policy  can be viewed here
This privacy policy will explain how our organisation uses personal data we collect from you when you completing one of our forms www.actcic.org.uk/formsprivacy
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http://www.actcic.org.uk
Personal Details
First Name *
Surname *
Date of Birth *
Address *
Post Code *
Telephone *
Mobile *
Email *
Experience & Education
Please provide us with relevant information that you feel may assist us when assessing your expression of interest to work with us
Job Title/Profession/Expertise *
Qualifications/Awards/Certificates *
Relevant Experiences *
please outline any relevant expereince you may have in working with and supporting young people
Interests and Hobbies *
please indicate your interests and hobbies
Reference 1 with Contact Number *
please provide a reference, we will only contact them once yor through to the final stages.
References 2 with Contact Number
Current Hourly Rate / Salary
this is only required so we can calculate the value of your time and match this against any future applications for funding
Disclosure & Barring Service DBS Information
DBS formerly known as CRB Criminal Record Bureau  
Do you have a current DBS Check *
Are you registered for the DBS update service (online checking) *
Can you please provide your DBS Check Disclosure Number
if you dont have a current DBS please leave blank
Can you please provide your DBS Check Disclosure Date of Issue
MM
/
DD
/
YYYY
Any Other Information (that you feel will be relevant) *
Availability
This is to help give us a snapshot of your general availability, we understand this may change and will discuss with you more fully before scheduling for any sessions  
Availability *
Required
I declare that the information I have provided herein is true and to the best of my knowledge. *
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