If you need any help with this form, you can call us on 0300 222 5742.
You need to get the person's consent before you apply for the service for them.
They need to be at least 16 years old to use the Kickstart service.
There is advice for disabled people looking for work and advice for disabled people in work on our website.
You can also call our helpline for advice on 0808 800 3333.
Kickstart is a service for disabled people.
Register for Kickstart
Kickstart is not available in Wales.
Working on Wellbeing is our employment training and support programme for disabled people in Wales.
Find out about Working on Wellbeing
There is also advice for disabled people looking for work on our website.
You can call our helpline for advice on 0808 800 3333.
You need to be at least 16 years old to use the Kickstart service.
