User
Personnel monitoring form

Induction Stage
Student Profile – Personal monitoring form

These surveys are completed in-house by each person undertaking a Wheels' course.
These used to build a profile on the types of young people with whom we are working.
Information is in the strictest confidence and no names will be stored on computers.

Any question that the young person is unhappy to answer should be shown in the 'No Answer' selection.

Student Profile - Personal monitoring form


Gender?*
Are you male or female?
Age?*
How old are you
Older (Please Specify)  :  
Area where you live?*
Select the one that best suits where you live
Other (Please Specify) :  
Religion or Belief?*
Other Religion :  
Sexual Orientation?*
Do You Have A Disability?*
Yes
No
Prefer Not To Say
If Yes, Please State Details :  
Race?*
Other (Please Specify) :  
Type of living accommodation?*
Who do you live with
Other (Please Specify) :  
Are your parents together?*
YesNo
Do either of your Parents/Guardians have a full-time job?*
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