NCS Application Form Please fill out the Application Form below and we will be in touch shortly. How did you hear about NCS? ---School/CollegeAdvertMedia Article/ProgrammeWord of MouthFacebook/Twitter/Social mediaThrough a youth group/organisationOther First Name (required) Surname (required) Street Address (required) Town/City (required) Postcode (required) Your Email (required) Contact telephone number (required) Date of Birth (DD/MM/YY) (required) Parent or Guardian Details First Name (required) Surname (required) Contact telephone number (required) Email (required) Name of school or college last attended Which programme are you interested in? ---Autumn 2017Summer 2017 Eligible for free school meals? ---YesNoN/A What best describes your ethnic background? ---White BritishIrishTraveller of Irish heritageGypsy/RomaAny other white backgroundIndianPakistaniBangladeshiAny other Asian backgroundChineseBlack CaribbeanBlack AfricanWhite and AsianAny other mixed backgroundAny other black backgroundAny other ethnic groupPrefer not to say What is your faith/religion? ---ChristianBuddhistHinduSikhMuslimJewishOtherNoneDon't knowPrefer not to say Do you have any disabilities? YesNo If you answered yes please give more details Wave Choice - if you know your choice of start date already please select now ---Summer Wave 2 - 3rd July 2017Summer Wave 3 - 10th July 2017Summer Wave 4 - 24th July 2017Summer Wave 5 - 31st July 2017Summer Wave 6 - 7th August 2017 Online Payment NCS Summer £50.00NCS Autumn £50.00 7 day assembly offer of £35 (phone 02380 770713 to confirm place) Do you face any barriers to participating in activities (please select all that apply) ---History of offendingBlind or partially sightedDeaf or hard of hearingAutistic Spectrum Disorder/Asperger SyndromeIn or recently in careA statement of special educational needsMental health difficultiesWheelchair user or mobility difficulties NCS asks for a contribution of £50 to cover the overall costs of the programme. You can either pay online or send payment to Youth Options (cheques made payable to Youth Options). Financial support to cover these costs may be available if required (for example if the participant is entitled to free school meals). Your place on the programme is only guaranteed when payment is recieved. Once you have completed and submitted the form please click here to purchase your chosen camp.