Disability Confident Employer Scheme 
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1. Name
2. Email
3. Do you have a Disability or an Impairment? *
Required
4.1. If you chose "Other" please specify.
5. Do you require assistance to attend an interview if selected? E.g. a support worker or interpreter.  Please state below. 
6. Do you require the application form to be in large print or audio? 
7. If applicable, please let us know of any adjustment requirements *
8. Any other information
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