Skip over main navigation
Sign up
Log in
Basket:
(0 items)
Bikeworks CIC
Search
Twitter
Facebook
YouTube
LinkedIn
Instagram
All Ability Cycling
Donate
Search
Search
Menu
About Us
Who we are
Our impact
Our team
Trustees
Our staff
Our partners
Work for us
Repair shop
General FAQs
Why cycling
Benefits of cycling
Getting started
Success stories
News
All Ability
Inclusive Active Travel Conference 2020
Call For Papers
What is All Ability?
Find an All Ability session
What to expect
Volunteer at All Ability
All Ability Shop
Ride Side-by-Side
What is Ride Side-by-Side?
Book a Taster Session
Crowdfunding: Ride Side by Side
Cycle Training
About-Cycle Training
Book Adult Cycle Training
London Borough of Tower Hamlets
London Borough of Hammersmith & Fulham
London Borough of Hounslow
Instructor Training
What is Instructor Training?
Programme Calendar
What to Expect
Register Your Interest
RPL route for current instructors
Book an RPL Level 2 Route
Train the Trainer
Dr Bikes & Teambuilding
Dr Bikes
About Dr Bikes
Register your Interest
Community Dr Bikes
Hounslow Dr Bikes
University of Cambridge
Southend SEAT
Team building
Charity Bike Factory
Register your Interest
Employee health and wellbeing
Maintenance Courses
Book a maintenance course
City & Guilds Cycle Mechanics
City & Guilds Level 1
City & Guilds Level 2
Register Your Interest
Bespoke Maintenance Courses
About Bespoke Courses
Register your Interest
Gift Vouchers
Cycling for Wellbeing
Program Overview
FAQs
Referral Form
Booking Form
Promotional Resources
Friends and Great Places
Cycle Into Work
Cycle Into Work
Employability Courses
FAQs
Referral Form
Get involved
Sign up to our Newsletter
Give us your feedback
Donate
Fundraise for us
Fundraising events
Volunteer for Bikeworks
Admin
Log in
Basket:
(0 items)
Cycle Into Work Referral/Enquiry Form
Use this form to refer yourself or someone to the Cycle Into Work programme, or if you have a general enquiry.
If referring someone else, please make sure they have given permission to be contacted by us and note that all information will remain confidential and only be shared on a need-to-know or anonymised basis.
Applicant Name
(required)
This field is required
Applicant Phone Number
(required)
This field is required
Applicant Email Address
Please enter a valid email address
Applicant Borough
(required)
This field is required
Are you enquiring for yourself or referring someone else to the Cycle Into Work Programme?
(required)
Please select a value
-- Please Select --
Referring someone else
It’s for myself
If booking on behalf of yourself- were you referred to this program by someone else?
(required)
Yes
No
NA
If Yes Who referred you (eg Job Centre, Housing association)?
If booking on behalf of yourself - Are you currently unemployed?
(required)
Yes
No
NA
If Yes How long have you been unemployed?
If you are referring someone else: Your Name (Write "NA" if you are applying for yourself)
(required)
This field is required
If you are referring someone else: Your Phone Number If you are referring someone else: Your Name (Write "NA" if you are applying for yourself)
(required)
This field is required
If you are referring someone else: Do we have permission from the person to be contacted directly?
(required)
Yes
No
NA
If referral for someone else: Your organisation name (Write "NA" if you are applying for yourself)
(required)
This field is required
If referral for someone else: Do you think the person can complete a virtual interview themselves or will they need support?
-- Please Select --
They can do it themselves
They will need support
If referral for someone else: Type of Referral (Select "NA" if you are applying for yourself)
(required)
Please select a value
-- Please Select --
Job Centre Referral
Community Organisation (eg housing association) Referral
Health professional /Social Prescriber Referral
Personal Referral
Other
NA
Demographic information for Participant (If booking on behalf of someone else answer to the best of your knowledge or select “Prefer not to say” and participant will be asked directly if they wish to give this information)
Age
(required)
Please select a value
-- Please Select --
16-17
18-24
25-34
35-44
45-54
55-64
65+
Prefer not to say
Gender
(required)
Please select a value
-- Please Select --
Female
Male
Other
Prefer not to say
Please describe any learning difficulties, disabilities, or sensory needs here.
(required)
This field is required
Please type your question/comments/message here
Send
honeybeeritb2