Kickstart

If you need any help with this form, you can call us on 0300 222 5742.

You must answer all the questions marked with an asterisk (*).

About you

Are you at least 16 years old? Yes No

You need to be at least 16 years old to attend the Kickstart service. On our website you can find advice for disabled job seekers and disabled people in work or you can call our helpline for advice on 0808 800 3333.

Are you disabled or do you have an impairment or condition? Yes No

Kickstart is a service for disabled people.

Where do you live? London Leeds Somewhere else

Which borough do you live in?

Kickstart is only available for people that live in one of these areas. On our website you can find advice for disabled job seekers and disabled people in work or find out about our national Support to Work service. You can also call our helpline for advice on 0808 800 3333.

First name

Last name

Postcode

Contact details

To use this service we’d like to contact you by phone and by email before arranging a face to face meeting. Please tell us if you have any access requirements.

We will not use your details for marketing or fundraising.

Phone number

Is there anything we can do to help you access this service?

You’re in control. You can change your preferences at any time by emailing kickstart@scope.org.uk or speaking to an adviser. You can also read about how we protect and use your personal information in our Privacy Policy.