Training Centre Partner Portal
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This form must be completed to refer a participant into the More Positive Together Steps Programme. These details will be stored securely and retained at least until 31 December 2026, in compliance with the Data Protection Act 1998. This information will be used to evaluate this project and to report to the European Social Fund for monitoring purposes. You may be contacted to discuss your involvement in the project. For the purposes of the Data Protection Act 1998, the Department for Work and Pensions is the data controller in respect of information processed which relates to your participation in the project funded by the European Social Fund.

MPT Steps Self-referral

preferred mode of contact *
Phone
Email
Are you between the ages of 16 and 65? *
Yes
No
Are you currently in paid work of any kind, including any zero hours contracts? *
Yes
No
Does you live in Social Housing? *
Yes
No
If ‘Yes’ which Housing Association? *
Adactus Housing
Blackpool Coastal Housing
Contour Housing
Great Places
Onward
Key Unlocking Futures
Newground
Places for People
Progress Housing Group
Regenda
Symphony Housing
Your Housing
Unknown
Other
Prefer not to say
The information provided in the form is, to the best of my knowledge, accurate. *
Yes
No
I am not in paid work of any kind, including any zero hours contract. *
Yes
No
If I have ticked a ‘Prefer not to say’ option anywhere on this form, I confirm that I am refusing consent for this information to be collected. *
Yes
No
I give permission for my personal details to be shared with the partners who are signatories to the Information Sharing Agreement involved in the delivery of this project. A copy of the information sharing Agreement can be found within the privacy policy here https://www.activelancashire.org.uk/privacy-policy *
Yes
No
I understand that this information will be retained until at least 31 December 2026 for evaluation purposes. After that time, it will be destroyed in a secure manner. *
Yes
No
I may be contacted at any time to discuss my involvement in the project. *
Yes
No
I understand that the DWP, Government Internal Audit Agency, statutory bodies and signatories to the Information Sharing Agreement may request to see this information at any time and that it can only be shared in a secure manner and never emailed. *
Yes
No
I know that the support I will be offered is funded by the European Social Fund *
Yes
No
Lotto Sport
European Union
Active Partnerships
NHS
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