Achieve Programme 2020 Application Form

First Name:*
Last Name:*
Membership Number:*
Email Address:*
Phone Number:*
Linkedin URL:
Showreel URL (if you have one):
Not part of the selection procedure
Address:
Address Line 2:
City:
Postcode:

YOUR EMPLOYMENT DETAILS (COMPLETE ALL FIELDS):
Which sector do you work in?* (please select)

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What stage are you at in your career?*

Early career: in your first or second job.Experienced practitioner: you have a number of years of experience and are aiming higher.Senior practitioner: you have already senior position but not yet reached your full potential.

What challenges, if any, have you experienced in progressing your career?

Please upload a PDF of your CV (2 pages max):

SUPPORTING STATEMENTS
Please tell us why you would like to participate in the programme

Are you applying for one of the reduced fee places?

YesNo

If yes, please tell us why you feel you should be allocated one of those places.

DIVERSITY MONITORING FORM
What is your age?

What is your ethnic background?

If you have chosen 'any other' on your ethnic background, please specify:

What is your sexual orientation?

Do you consider yourself to have a disability or health condition?

If yes, do you have specific requirements that you need to tell us about that would help you take part in the programme?