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General
Intro
I understand that a referral does not mean that I am guaranteed a place on the programme.
Yes
No
I have been given/had a look at information about the programme and what is involved
Yes
No
I have checked I meet the eligibility criteria.
Yes
No
I understand that the programme is running as a Randomised Control Trial (RCT), and once registered, young people have a 50% chance of receiving a paid work placement, as long as there are placements available.
Yes
No
How did you hear about this programme?
Online search engine (e.g. google)
Social media platform (e.g. instagram or facebook)
A previous participant recommended it to me
Someone else recommended it to me
From a Local Delivery Partner (for e.g. youth club, council, employment & training programme, etc.)
Other
Others - How did you hear about the programme ?
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Who is completing this form?
*
I am an adult, completing on behalf of a young person
I am completing this for myself
Your Details (young person)
Date of Referral (Today's Date)
Your Full Legal Name (as it appears on passport or ID)
*
*
Preferred Pronouns
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She/her
He/Him
They/Them
Other
Other Pronoun
*
What is your preferred name? (Enter 'as above' if it's the same as your legal name)
*
*
Date of Birth
*
*
Gender
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Male
Female
Non-binary
Other
Prefer not to say
Other - Gender
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Ethnicity
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Asian Bangladeshi
Asian Chinese
Asian Indian
Asian Pakistani
Black African
Black Caribbean
Mixed White and Asian
Mixed White and Black African
Mixed White and Black Carribean
Not stated
Other
Other Asian background
Other Black / African / Caribbean background
Other Mixed / Multiple ethnic background
Other white background
White English / Welsh / Scottish / Northern Irish / British
White Gypsy or Irish Traveller
Other - Ethnicity
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Email Address
*
*
*
Please retype your email address
*
*
Phone Number
*
*
Are you still in school?
*
Yes
No
Have you participated in programmes or services with one of the Summer Jobs 2026 Local Delivery Partners in the last 6mths?
*
No
Dragon Hall - Soap Box
Northside Youth and Community Connections
Orange Bow
Project Zero WF
Spark!
Spiral Skills
Think Forward UK
Youth League
GMYN
Nurturing Foundations
Power 2
Wigan Youth Zone or Bolton Lads & Girls Club
Flying Futures
Sheffield Futures
Youth Cymru
Catch 22 (West Midlands only)
Sport 4 Life
Sporting your Futures
Referrer Details
New Section
Referrer's Full name
*
Referrer's contact number
*
Referrer's email address
*
*
Referrer's Organisation name (if parent/carer enter N/A)
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Organisation type (if parent/carer enter N/A)
Children and Families Services
Voluntary, community or social enterprise (VCSE)
Criminal Justice system
Education
Health care
Housing and homelessness support
Integrated care system
Local Authority
Police
Probation services
Social Care
Other
Was the young person known to you or your organisation prior to this referral?
Yes
No
Your relationship to the young person
Parent/Carer
Youth Justice Worker
Work Coach/Jobcentre worker
Teacher/School staff
Social Worker
Youth worker
Support worker (e.g. housing, mentoring, charity support)
Employer/training provider
Self-referral
Other
How much does the young person know about The Summer Jobs Programme?
Nothing, they do not know they are being referred
A little, they know they are being referred
A lot, they know about the programme and that they are being referred
Do you consent to being contacted about the outcome of the young person's allocation into the Summer Jobs programme?
Yes
No
Eligibility Criteria
Eligibility Criteria
How old are you?
*
I will be 16 on or before May 22nd, 2026
17
18
19
I am 20 and I won't turn 21 until after September 1st, 2026
Other
Do you have the right to work in the UK? Check here https://www.gov.uk/prove-right-to-work
Yes
No
Can you take part in 25 hours of employment each week over the Summer (with reasonable adjustments, if you need them)?
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Yes
No
Maybe
Are you available to take part in at least 5 of the 6 weeks of the programme over the Summer? This must include the first prep week.
*
Yes
No
Maybe
Are you currently employed for more than 15 hours per week?
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Yes
No
Are you studying towards a degree at the moment?
*
Yes
No
How would you rate your level of spoken English?
Beginner - I have recently started learning
Intermediate - I speak and understand English enough to communicate
Advanced - I speak and understand English well
Are you currently facing a charge for a serious offence?
Yes
No
Not sure
What is the offence you are charged with?
*
At the start of the programme, in July 2026, will you be living somewhere that is part of the 'secure estate'? This includes Young Offender Institutions (YOIs), Secure Training Centres (STCs), and Secure Children's Homes (SCHs), for example.
Yes
No
Uncertain - proceedings still in progress
Which area will you be living in during the programme (July-September 2026)?
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South Wales
Greater Manchester
North West
North East
West Midlands
London
Yorkshire and the Humber
Bristol
None of the above
Which area of South Wales do you currently live in (or you can travel to in 30 mins or less)?
Swansea
Newport
Cardiff
None of the above
Which area of Greater Manchester do you currently live in (or you can travel to in 30 mins or less)?
Wigan
Salford
Bolton
Rochdale
Oldham
Bury
Manchester
Trafford
Stockport
Tameside
None of the above
Which area of the North West do you currently live in (or you can travel to in 30 mins or less)?
Liverpool
Preston
None of the above
Which area of the North East do you currently live in (or you can travel to in 30 mins or less)?
Middlesborough
Stockton-on-tees
None of the above
Which area of the West Midlands do you currently live in (or you can travel to in 30 mins or less)?
Birmingham
Walsall
Sandwell
Coventry
Dudley
Wolverhampton
Solihull
None of the above
Which area of London do you currently live in (or you can travel to in 30 mins or less)?
Barking & Dagenham
Barnet
Bexley
Brent
Bromley
Camden
Croydon
Ealing
Enfield
Greenwich
Hackney
Hammersmith
Haringey
Harrow
Havering
Hillingdon
Hounslow
Islington
Kensington and Chelsea
Kingston
Lambeth
Lewisham
Merton
Newham
Redbridge
Richmond
Southwark
Sutton
Tower Hamlets
Waltham Forest
Wandsworth
Westminster
None of the above
Which area of Yorkshire and the Humber do you currently live in (or you can travel to in 30 mins or less)?
Sheffield
Leeds
None of the above
Are you already supported by, or attending services run by a youth organisation delivering the Summer Jobs Programme in your area?
No
Dragon Hall - Soap Box
Northside Youth and Community Connections
Orange Bow
Project Zero WF
Spark!
Spiral Skills
Think Forward UK
Youth League
GMYN
Nurturing Foundations
Power 2
Wigan Youth Zone or Bolton Lads & Girls Club
Flying Futures
Doncaster City Council
Sheffield Futures
Youth Cymru
Catch 22 (West Midlands only)
Sport 4 Life
Sporting your Futures
Please select all of the eligibility statements
*
Please provide a summary explanation in under 50 words
*