Grad Recharge Sign Up Form 
Please fill out this form to sign up for the Grad Recharge programme
Email *
Confirm Email Address *
Full Name *
Phone Number *
Preferred Contact Method
Postcode *
Address (First line) *
Do you have the legal right to work in the UK? Please select the type of right to work you currently hold: *
Required
If 'Other' for right to work, please specify:
Gender / Gender identity
If 'Other' for gender, please specify:
Ethnicity *
Have you experienced any of the following in the past 12 months that have affected your personal wellbeing, access to opportunities or ability to progress? *
Required
If 'Other', please specify:
I confirm I am a graduate of a STEM degree. *
Required
My degree is in:
I confirm I am not currently economically active. I understand this means that I have been out-of-work for four weeks and and not available to start work in the next two weeks 

Eligibility Note: To qualify for this programme, you must not be in any form of employment. This includes full-time and part-time roles.
*
Required
I confirm I am not currently taking part in any other funded programmes. *
Required
I confirm that I am currently a resident within the Manchester  City Council local authority area. (We will verify your postcode to confirm eligibility) *
Required
I have experienced mental health and/or wellbeing challenges in the past 12 months (self-identified). *
Required
How did you hear about the Grad Recharge programme?
If 'Other' for how you heard about us, please specify:
I consent to my data being stored and shared with Manchester Digital and its delivery and evaluation partners for the purposes of programme delivery and impact evaluation and aligned to the UK Government Funding retention requirements.

I am not from Manchester but would like to be considered for this programme if expanded into other areas of Greater Manchester.
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