Amactraining.co.uk
Course Application Form 2020-21
If you require more space, please provide an extra sheet of paper. If you need help choosing a course and completing this application form, please telephone 01227 831 840.
|1. PERSONAL DETAILS |
|Title | |Male |[pic] |Female |[pic] |Date of Birth | |
|(Mr/Mrs/Miss/Ms/Dr) | | | | | | | |
|Surname | |Telephone | |Nationality | |
|First Names | |Mobile Telephone | |National Insurance Number | |
|Home Address | |Previous Student? | |Unique Learner Number (if | |
| | | | |known) | |
| | |Email Address | |
|2. COURSE DETAILS Please enter details for the course/s you would like to study. |
|Course Title |Level |Venue and Start Date (if applicable) |
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|3. PRIOR QUALIFICATIONS OR ACHIEVEMENTS |
|A) Is English your first language? Yes [ ] No [ ] If no, please indicate any qualifications in English you have below. |
|B) Please enter below any qualifications you have that are relevant for the entry requirement to the course you are applying for. Evidence may be required to |
|complete enrolment. |
|Qualifications/Training taken |Organisation |Level/Grade |Date Achieved |
| | | | |
| | | | |
|4. EMERGENCY CONTACT DETAILS Please give the details of someone who can be contacted in case of an emergency. |
|Name | |
|Telephone | |Relationship to you | |
|5. EQUAL OPPORTUNITIES Please complete the following information accurately to help us comply with the Equality Act 2010 and ensure that you are treated fairly. |
|All information is confidential, seen by a limited number of staff and our reporting mechanisms guarantee data protection. Please indicate your ethnic group: |
|Asian or Asian British – |[pic] |Black or Black British - |[pic] |Mixed/Multiple Ethnic Group – White and Asian |
|Bangladeshi | |African | | |
|6. SUPPORT FOR LEARNING |
|Amac wishes to support you in your learning and recognises that some students have a disablity or a learning difficulty. This information is completely |
|confidential and does not affect your application to Amac. If you feel you may require support during your learning, please specify (e.g. Visual impairment, |
|Dyslexia) |
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|If you have more than one disability or learning difficulty, please indicate which is your primary disability/learning difficulty? |
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|7. EMPLOYMENT/UNEMPLOYMENT STATUS Please tick ALL relevant boxes. (To be completed by Advanced Learner Loan students only) |
|Not in Paid Employment |In Paid Employment |
|Looking for work and available to start work |[pic] |Unemployed for: |Self employed? |[pic] | |
|Not looking for work and/or not |[pic] |Less than 6 |[pic] |Number of hours work: |Employed for: |
|available to start work | |months | | | |
|In receipt of Job Seekers Allowance (JSA) |
|No qualifications |[pic] |
|Entry Level e.g. Basic Skills |[pic] |
|Level 1 e.g. NVQ 1 or 5 or more GCSEs D-G or fewer than 5 at grades A-C or level Diploma/Certificate/Award |[pic] |
|Full Level 2 e.g. NVQ 2, 5 or more GCSEs A*-C, 2 or 3 AS levels, Level 2 Diploma/Certificate |[pic] |
|Full Level 3 e.g. NVQ 3, 2 or more A levels or level 3 Diploma/Certificate |[pic] |
|Level 4 e.g. NVQ 4 or HNC or Professional Diploma |[pic] |
|Level 5 e.g. Foundation Degree HND or NVQ 5 |[pic] |
|Level 6 e.g. Award, Certificate, Diploma Degree |[pic] |
|Level 7 e.g. Award, Certificate, Diploma Masters Degree |[pic] |
|9. PAYING YOUR COURSE FEES |
|The fee(s) I wish to pay £ (please tick appropriate box below) |
|Credit/Debit Card |[pic] |Advanced Learner Loan |[pic] |Payment Plan |[pic] |Invoice to Employer |[pic] |
|10. DATA PROTECTION STATEMENT |
|In accordance with the General Data Protection Regulation (GDPR), we have implemented this privacy notice ‘Privacy Notice for Students’ to inform you, as |
|students of our Company, of the types of data we process about you. We also include within this notice the reasons for processing your data, the lawful basis |
|that permits us to process it, how long we keep your data for and your rights regarding your data. This notice can be found on our websites allactive.co.uk |
|and amactraining.co.uk. |
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|How your Personal Information will be used for Advanced Learner Loan students |
|If you are paying for your course through an Advanced Learner Loan, personal information you provide is passed to the Education & Skills Funding Agency and the |
|Department of Education. You can view their own ESFA Privacy Notice at .uk. The information is used for the exercise of functions of these government |
|departments and to meet statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009, and for the exercise of |
|functions of the Crown, a Minister of the Crown or that government department. The information you provide may be shared with other organisations for education, |
|training, employment and well-being related purposes, including for research. You may be contacted after you have completed your programme of learning to |
|establish whether you have entered employment or gone onto further training or education. |
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|You can opt in for contact from government departments for other purposes by ticking any of the following boxes if you wish to be contacted: |
|(1) About courses or learning opportunities [pic] (2) For surveys and research [pic] (1) By post [pic] (2) By phone [pic] 3) By e-mail [pic] |
|11. STUDENT DECLARATION |
|I understand the implications of my choice of course/s. |
|I understand the entry requirements of each course and that the learning programme suits my needs, progression and personal ambitions. |
|I understand that if I withdraw from my course, I will still be liable for fees. |
|I confirm the information I have given in this application is correct and complete to the best of my knowledge. |
|I confirm that I have read and understood the Amacsports Ltd Course Terms and Conditions. |
|If I am under 18 years of age then I authorise Amac to provide appropriate information (relates to my progress and attendance on enrolled courses or in the event|
|of a cause for concern or a medical emergency) to my parent(s) or guardian(s). Please ask for this form to also be countersigned by your parent or guardian. |
|If my course is being sponsored (includes where an employer allowing time-off to do course work) then I authorise Amac to provide appropriate information to my |
|employer or sponsor. |
|I understand this form is a learning agreement between Amacsports Ltd and myself. |
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|Applicant’s Signature Date |
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