Let’s Go! Application Form Download PDF Application Section 1 - About You * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Date Of Birth * MM DD YYYY PPS Number * Phone * (###) ### #### Email * Eligibility Criteria: To be considered for the Let's Go! program, applicants must meet the following criteria: 1. Be an adult (18+) with Down Syndrome. 2. Have a strong interest in training and employment opportunities. 3. Be able to participate in a structured learning environment. 4. Commit to attending the full duration of the program. 5. Have basic self-care and communication skills. To allow us have a better understanding of points 2, 3 and 4 above, can you forward on the following please and place a tick in the relevant box: 1. Details of any training courses completed. 2. Any current or past Individualised Education Plan. 3. Any current or past Personal Development Plan. 4. Details of any current or past work experience. Please note: We have a limited number of spaces each year. In the case that a program is oversubscribed, applicants may be placed on a waiting list. In this instance places will be offered on a “First come first served basis” Section 2 – Contact Person Do you want us to speak with someone who helps you? If yes, please give us their details. First Name Last Name Relationship to you (e.g. parent, sibling, support person): Parent Sibling Support Person Other Phone (###) ### #### Email Section 3 - Emergency Contact Person Name * First Name Last Name Relationship to you (e.g. parent, sibling, support person): * Parent Sibling Support Person Other Phone * (###) ### #### Email Section 4 – Your Interests and Skills What do you like to do? Music Acting Working With People Working In Shops Sports Other What are your talents or things you are proud of? What kind of work would you like to do in the future? Section 5 – About you and support needs Do you need any support with reading, writing, travelling or other things? Please tell us how we can support you best. Do you use any assistive technology or communication aids? Yes / No — If yes, please tell us more: Yes No Section 6 – Programme Preference We offer three different programmes. Please select which one you would like to join (you will only be in one group): * Programme 1: 4 days – Monday to Thursday Programme 2: 2 days – Monday and Tuesday Programme 3: 2 days – Wednesday and Thursday Section 7 – Saying Yes to Apply By signing this form, you are saying: * ✅ “Yes, I would like to apply to join Let’s Go!” 🔒 “I know that my information will be kept private and only used for this application.” 📝 “Everything I wrote in this form is true and correct.” 📅 “I understand that there are a limited number of places in Let’s Go!” 💡 “Even if I meet all the criteria, I might not get a place this time.” I agree to the above If someone helped you complete this form: Name of Person Helping First Name Last Name Thank you!
