TRACs Training Programme - 2009/10

Title:
[*]Surname:
[*]First Name:
Organisation:
[*]Home Address:
Postcode:
[*]Telephone:
[*]E-mail:

Gender:

*Date of Birth (dd/mm/yyyy):

What is your ethnic group?:

Do you consider that you have a learning difficulty?:

Do you consider that you have a disability?:

* If you have answered yes to either of the previous two questions please tell us your disability or learning difficulty so that we can see how we may be able to help you in your learning. Alternatively, should you prefer to discuss any additional needs in confidence with your tutor please tick here.

Please give details of any other special needs you may have such as diet, wheelchair access, loop or signing?

[*]When were you last in formal learning or on a course over approx 12 hours long?:

[*]What is the highest level qualification you have?:

[*]Employment Status: are you currently?:

CONFIRMATION
When we receive your booking form we will send you a confirmation letter with a map to the venue, or a reserve letter for courses that are already full. Please book early to avoid disappointment as spaces are limited and they are allocated on a first come, first served basis. If a course is full we will put you on the waiting list in case of cancellations. If you are completing this form online payment must be sent by post immediately. In case of difficulty, please contact us.
 
I am sending a cheque, made out to Community First for Portsmouth, for -- Select -- £22 £30 £34 £35 £60 £70 £85 £90 Applying for free bursary place
 
CANCELLATION
Please let us know as soon as possible if you cannot attend because we have waiting lists for our courses. If you do not let us know that you cannot attend, somebody else may miss out on the course. Course fees will only be refunded with a minimum of two week's notice in advance of a course.
 
Bursary: The course you are enrolling on is subject to a fee. For some courses we have a limited number of bursaries (free places) available. One of the eligibility criteria is receipt of income related benefits. If you are receiving benefits we would need to see an original copy of one of the following documents as evidence. Examples of acceptable evidence as proof of receipt of an income related benefit include:
 

- Written notification of entitlement (received by all recipients)
- Benefit book
- Portsmouth Leisure card
 

Please indicate the benefit(s) you receive

Income Support
Working Tax Credit
Job Seekers Allowance
Housing Benefit
Council Tax Benefit
Pension Credit
Other (provider discretion)
Unwaged Dependant
Asylum seeker receiving the equivalent of income based benefit

For other eligibility criteria please see our Bursary Policy. To apply for a free place please contact us.

Data Protection Act 1998:
For LSC Funded Courses: The information you provide on this form will be passed to the Learning and Skills Council (the LSC). The LSC is responsible for funding and planning education and training for young people and adults in England, and is registered under the Data Protection Act 1998. The information you provide will be stored on a secure electronic database and may be shared with other organisations for the purpose of administration, careers / other guidance and statistical and research purposes. Other organisations with which we will share information include, the Department for Children, Schools and Families, Department for Innovation, Universities and Skills (DIUS), Connexions, Higher Education Statistics Agency, Higher Education Funding Council for England, educational institutions and organisations performing research and statistical work on behalf of the LSC or its partners. The LSC is also a co-financing organisation and uses European Social Funds from the European Union to directly or indirectly part-finance learning activities, helping develop employment by promoting employability, business spirit and equal opportunities, and investing in human resources. Further information about partner organisations and what they do, may be found at http://www.lsc.gov.uk, and by following the links to data protection. We will use the information you provide on your booking form to inform the Tutor who will do the training. We will also use it to keep you up-to-date on forthcoming training and news. If you prefer for this to NOT happen please tick here.
At no time will your personal information be passed to organisations for marketing or sales purposes.
 
From time to time students are approached to take part in surveys by mail and phone, which are aimed at enabling the LSC and its partners to monitor performance, improve quality and plan future provision. Tick this box if you do not wish to be contacted by the LSC or its partners in respect of surveys and research.
Tick this box if you do not wish to be contacted by post by the LSC or its partners from time to time about courses or learning opportunities relevant to you.