Job Outcome Declaration

If you’ve started a job while enrolled on one of our courses, please complete this simple form to let us know.

"*" indicates required fields

Name*

Given Name Family Name

Telephone Number

Email

Date employment started*

Day

Month

Year

Confirmation of employment*

I confirm that I have been employed for 16 hours or more per week for at least four consecutive weeks.

Before you started your new job, were you claiming benefits related to unemployment?*

Yes

No

Confirmation that unemployment benefits have stopped*

I confirm that I have stopped claiming benefits relating to unemployment since gaining this job

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Signature*

Please draw your signature either with your mouse or if you have a touchscreen with your finger or stylus.

Today's Date:*

Day

Month

Year

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Staff Notes

Comments where appropriate