COURSE REGISTRATION FORM

COURSE REGISTRATION
Name

First NameLast Name
Date of Birth

DayMonthYear
Gender
Your Address

Street Address

Street Address Line 2

City

Post code
Email
example@example.com
Mobile Phone Number

Phone Number
Do you have a previous City and Guilds Certificate Number
If so we can register you with the same number to keep consistency
Do you have current Electrical Skills/Knowledge/Training / Qualifications
Please identify your current skills, Qualifications, Knowledge or experience
C&G Electrical Installation Courses I would like to undertake (Tick all that apply)

Other
Did you receive extra time in exams at school or college?
If you did then proof may be required by C&G if extra time is allowed
Do you have one of the following? Dyslexia Dyscalculia. Dyspraxia.
If so in order to get extra time in exams C&G may require proof
Do you have any medical or physical problem which would affect you completing practical assessments or taking exams on a computer ?
Or might affect you accessing the first floor or a task board with Electrical tools
Date submitted

DayMonthYear
Signature

GDPR I agree for the purpose of undertaking the course/ training applied for the company and Awarding Organisation can store relevant information and assessments as required for a period of 3 years:
Please Select what you would like us to do for you:
Please verify that you are human
Should be Empty: