Scarborough TEC Distance Learning Application Form

Choice Of Course(Required)

Please choose your course completion method(Required)

How did you hear about us?

Name(Required)

Title First Last

Date of Birth(Required)

Email(Required)

Legal Gender(Required)

Female

Male

Prefer not to say

Other

Permanent Home Address(Required)

Street Address Town/City Post Code

Telephone Number(Required)

Mobile

National Insurance Number(Required)

Employment Status(Required)

Were you in full-time education or training prior to enrolment?(Required)

Length of unemployment(Required)

Which benefits do you currently receive?(Required)

If other unemployed benefit

Amount of hours you work(Required)

Household Situation(Required)

Tick all that are applicable (no more than two)

No household member is in employment and the household includes one or more dependent children

No household member is in employment and the household does not include any dependent children

I live in a single adult (aged 18 or over) household with dependent children

None of these statements apply

I confirm that I wish to withhold this information

Have you lived in England or the European Union for all of the past 3 years?(Required)

Yes

No

Country of Residence(Required)

Please indicate your current status in the UK(Required)

Please note that if other than British we will need to see a copy of your passport or visa to help us determine your eligibility for funding for the course.

Nationality(Required)

Do you consider yourself to have a learning difficulty or disability?(Required)

If yes please select all that apply(Required)

Use ctrl & click to multi select

Are you currently undertaking any other qualification?(Required)

Yes

No

If Yes which qualification?(Required)

Education Information(Required)

Please add your level of qualification & the course name below, you can add up to six qualifications.

What is your highest level of Qualification?

Course name

I confirm that I have read the information about the course for which I am applying and specifically how the course is assessed. I am aware of the need to access company policies and procedures where applicable (Safe Handling of Medication and Working with People with Mental health Needs) and any other requirements as detailed in the How Assessed section of this website. I am aware of the time commitment and assessment requirements and can commit to these requirements. I am aware of the £125 non-completion fee for which I am liable if I have to be withdrawn from the course.

I am aware of the time commitment and assessment requirements and can commit to the above requirements.(Required)

Yes

Why do you want to take the course/training for which you have applied ?

By the TEC Partnership and ESFA

You can agree to be contacted for various purposes by selecting the following boxes

The information you supply is used by Learning Records Services (LRS). The LRS issues Unique Learner Numbers (ULN) and creates Personal Learning records across England, Wales and Northern Ireland and is operated by the Education and Skills Funding Agent, an executive agency of the Department for Education (DfE). For more information about how your information is processed and to access your Personal Learning Record please refer to www.gov.uk/goverment/publications/irs-privacy-notices

Terms & Conditions(Required)

I agree to the Terms & Conditions and understand that scarboroughtec.ac.uk has a legitimate interest to process the data that I have submitted. See our Terms and Conditions and Privacy Policy for more information.

Yes

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Name

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Distance Learning application form