Work Programme Exit Report Form (For Scotland and Wales)		
WPER1  |  (31 October 2013)		

Exit Reports must be completed and sent to Jobcentre Plus within 10 working days of them having submitted their request to you for the Report. 

About the customer	
					
Surname								NI Number										
					
Summary – Actions Agreed	
Please tell us below as much as you can about the actions agreed with the participant, including activities such as work / training or work experience the participant has completed / not completed, the period(s) that any work experience/employment covered, any reasons why actions were not completed. 	

Further Information	
					
Please state below any further information which will provide Jobcentre Plus with an insight to the participant, include for example:
 
•	Employability – your opinion on the participants employment prospects, the type of employment which might be most appropriate. 

•	Attitude – any changes in attitude and background you have noticed whilst having worked with the participant for 2 years and any known reasons for these changes.

•	Barriers to employment – any barriers that you have seen the participant overcome / are still to be addressed / have arisen whilst on Work Programme. Any health conditions or substance dependency the participant may have. 

•	Compliance – the level of compliance you have seen from the participant, including any possible reasons you might consider to be behind this behaviour and which may be useful in determining further support for the participant.

•	Any other information you feel might be useful to Jobcentre Plus and give an insight to the participant.	

Next Steps	
Please tell us below as much as you can about your recommendations to Jobcentre Plus on the most appropriate next steps for the participant. This may include work experience, community work, further training, more job search activity or In work support.	

Provider details	
					
Prime Provider name 			Address		
					
Adviser name					
					
Phone number					
					
Email address			Date		
					
Jobcentre Plus details	
					
Office name and address