MANHOOD ACADEMY AIR CYCLE REGISTRATION FORM
Thank you for contacting us. For us to do what we do we need to ask a few questions. You are required to complete this online form. Thank you
Name of the person completing this form
(Your full name please)
What is your relationship with the young person
What is your contact email address?
What is your contact number?
Mobile or landline
The name of the young person
Is the young person aware of our programme?
Young person's full address and postcode
Young person's Age
Young person's contact details
Are their any other professional's involved?
Social Services, Youth Offending Services etc.
What is your assessment of the risks involved in working with this young person?
Why do you want this young master to join us?
What are your concerns?
Main Areas of Support
Negative Peer Group
Crime & Disorder
Mental Health and Lack of Expression
Name of School
Are their any orders, sanctions or anything else that would prevent us working with this young person?
The investment attached to this AIR cycle is £70 Will you make payment
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