PDTT Course Registration Form

ENROLMENT FORM 2021/22

All sections MUST be completed, failure to do so may delay your enrolment. If you need help with this form please ask at reception.
part 1 - PERSONAL DETAILS
COURSES - Please select which course are you applying for? *
FULL NAME: *

First Name Middle Name Last Name
DATE OF BIRTH: *

Day Month Year
GENDER: *
FULL ADDRESS: *

House/Flat No and Street

Address 2

Borough Postcode

Emergency Contact: Name and contact details
Contact Number: *
Please enter a valid phone number.
Email: *
example@example.com
NI Number *
Please enter your National Insurance number
Please state preferred method of contact: *

part 2 - ETHNICITY
Please choose what is best describes your ethnic group *
Collection Of Equality Information is to help make things better. It tells organisations where to direct services and shows if certain people aren’t making the most of services. It can also help make sure that you get the right slice of what you’re entitled to. To put things simply, we can’t change anything without your help.
part 3 - LEARNING DIFFICULTY/DISABILITY/HEALTH PROBLEM

We offer additional support to help you achieve to the best of your ability. Please tell us what support you may need. This information will be treated as confidential and will only be used to help us ensure you get the correct support.
Do you consider yourself to have any long term disability, health problem or any other learning difficulties? *

YES NO
If 'YES' Please select one that applies you.
YOUR HOUSEHOLD SITUATION - Please tick one of the following that applies you. *

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 Single adult household with dependent children None of the above apply

part 6 - PRIOR ATTAINMENT/QUALIFICATIONS
Please tick your highest qualification/attainment prior to starting the course. *

None Level 2 (GCSE) Level 4 (Degree) Entry Level Level 3 (A levels) Level 5 or above Level 1 Other Qualification level not known
Please indicate the highest prior qualification achieved in the past.

Qualification Tilte Level/Grade Certificate Available
PLEASE UPLOAD YOUR DOCUMENTS REQUIRED IN SUPPORT OF YOUR ELIGIBILITY

(Please upload copy of your ID/passport, proof of Benefit, for employed payslips/P60 and proof of address)
Cancel of
part 7 - STUDENT LEARNING AGREEMENT

You must sign so we can process your application.
I declare that:
- I have received sufficient information and guidance about the course I am going to do and believe it is at the right level for me.
- I agree to abide by the terms of the Student Learning Agreement (available from Centres and online Laser account).
- I know that I must comply with the Plagiarism's Policy and Procedures, to ensure I do not commit or collude with another person to commit plagiarism.
- The information I have given is true and accurate
- I understand that the information I have given is held by PDT in its original, electronic and other formats and that it will be used by PDTT staff for enrollment and reporting purposes.
- I have been made aware that this/these courses are funded through the Greater London Authority (GLA).
Applicant Signature: *

Clear
Date: *

Day Month Year
I have completed all sections of this form.

DATA PROTECTION

How We Use Your Personal Information

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). I is to inform learners how their personal information will be used by the DfE, the ESFA (an ececutive agency of the DfE) and any successor bodies to these organisations.

For the purpose 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 SfE to exercise its functions and to meet its statutory reponssibilities, 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 purpoeses.

Your information may be used for education, training, employemnt and well-being related purposes,including for research. Futher information about use of and access to your personal data, details of organidsations with whom we reguslarly share data, information about how long we retain your data, and how to change your consent to being contacted, please visit: https://www.gov.uk/government/publications/esfa-privacy-notice
Learner agrees to be contacted:

About courses or learning opportunities For survey and research
HOW DID YOU HEAR ABOUT US? *

PDT Leaflet PDT Website (www.pdt.org.uk) Word of Mouth Previous student
Please write the name of the person, who referred you for the course?
This section only applies if you tick 'Word of Mouth'
Should be Empty:

ENROLMENT FORM 2021/22

part 1 - PERSONAL DETAILS

part 2 - ETHNICITY

part 3 - LEARNING DIFFICULTY/DISABILITY/HEALTH PROBLEM

part 4 - RIGHT TO WORK/LIVE

part 5 - EMPLOYMENT STATUS

Proof of Entitlement

Why do you need to provide evidence?

part 6 - PRIOR ATTAINMENT/QUALIFICATIONS

part 7 - STUDENT LEARNING AGREEMENT