How did you hear about us?
First Name
Surname
Date of Birth
Borough
Slough
Windsor & Maidenhead
Address
Please provide proof of address (jpg, png or pdf)
Mobile Number
Landline Number
Email Address
National Insurance Number
Emergency Contact First Name
Emergency Contact Surname
Emergency Contact Relationship
Emergency Contact Number
Immigration Status
British
EU Settlement/pre-settlement
Work Permit
Please provide evidence of ID to a member of staff (eg. passport, ID card, driving licence) and evidence of your Right to Work documentation (e.g. passport, Biometric Residence permit or online verification) (jpg, png or pdf)
If you have a BRP/ EU Settlement Status, please visit https://www.gov.uk/prove-right-to-work and share your code with us:
Have you lived in the UK for 3 years or more?
Date Entered UK
if not, are you a refugee or Asylum Seeker and have you lived in the UK for 6 months or more?
Date Entered UK
Are you an unpaid Carer for an adult or child
Yes - Adult
Yes - Child
No
What is your Employment Status
Unemployed and available to start work now
Unemployed and not available to start work now
Employed
Self Employed
In full-time education
Retired
Volunteer
How long have you been working in months?
Not Applicable
Up to 3
4 - 6
7 - 12
12+
How many hours do you work per week
Not Applicable
0 - 10
11 - 20
21 - 30
31+
If you are unemployed/not working/retired, how long for?
Not Applicable
Up to 6 months
6 - 11 months
12 - 23 months
24 - 35 months
Over 36 months
Are you claiming a benefit?
If yes, please specify
Not Applicable
Universal Credit
Job Seekers Allowance
ESA
Other
If yes, please state your gross annual income (before tax, yearly):
If you answered “yes” to the questions above, you may qualify for a fee discount/no fee. If so, please provide recent evidence (jpg, png or pdf)
What qualifications do you hold?
No Qualifications
Entry Level
Other qualifications below Level 1
Level 1 (5 or more with grades D-G)
Level 2 (5 or more A*-C GCSE/O Levels
Level 3 (A Levels)
Level 4 (HNC/QLF Level 4)
Level 5 (HND/QLF/Foundation Degree)
Level 6 (Bachelors Degree/Graduate Certs and Diplomas)
Level 7 or Above (PG Certs/Masters Degree)
If yes, please specify
If you have a disability, what are your needs in terms of reasonable adjustments in order to access the course and to attend the initial assessment online?
Ethnicity
English/Welsh/Scottish/Northern Irish/British
Irish
Other White
Indian
Pakistani
Bangladeshi
Chinese
Other Asian or Asian British
African
Caribbean
Other Black/African/Caribbean/Black British
White and Black Caribbean
White and Black African
White and Asian
Other Mixed/multiple ethnic group
Arab
Other
If other, please state
If other, please state
Suitable Person Declaration (for Childcare and Education Programmes only) Are you on either of the 2 lists banning you from working with children or vulnerable adults imposed by the Independent Safeguarding Authority?
Are you disqualified from undertaking relevant childcare work under the relevant statutory provisions (Disqualification under the Childcare Act 2006)?
ESFA Privacy notice This privacy notice is issued by the Education and Skills Funding Agency (ESFA), on behalf of the Secretary of State for the Department of Education (DfE). It is to inform learners how their personal information will be used by the DfE, the ESFA (an executive agency of the DfE) and any successor bodies to these organisations. For the purposes of relevant data protection legislation, the DfE is the data controller for personal data processed by the ESFA. Your personal information is used by the DfE to exercise its functions and to meet its statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009 and to create and maintain a unique learner number (ULN) and a personal learning record (PLR). Your information will be securely destroyed after it is no longer required for these purposes. Your information may be shared with third parties for education, training, employment and well-being related purposes, including for research. This will only take place where the law allows it and the sharing is in compliance with data protection legislation. The English European Social Fund (ESF) Managing Authority (or agents acting on its behalf) may contact you in order for them to carry out research and evaluation to inform the effectiveness of training. Further information about use of and access to your personal data, and details of organisations with whom we regularly share data, information about how long we retain your data, and how to change your consent to being contacted, please visit: www.gov.uk/government/publications/esfa-privacy-notice. We want to contact you about our courses, if you agree tick any of the following boxes.
About courses or learning opportunities For surveys and research By post By phone By email None of the above
Date
Signature of Applicant
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