Name

Telephone

Address

I am interested in advice about...

Finding the right Job for me

A Work Taster

Gaining Confidence

Work Skills training

Self Employment

Childcare if I return to work

Life Skills support

Coming off Benefits

Working with a disability

Business Start-up

I cannot afford to come off benefits

I lack the skills to get a job I want

I lack the confidence to go for jobs

I go for the wrong jobs to suit me

My age counts against me

Childcare is too expensive

I never get an interview

I have a disability

I have a health problem

My address counts against me