16+ Funded College Course
Training For Electricians Ltd
Student Information
Student Name
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First Name
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Address
Street Address
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Health and Safety Induction Form
Do you have any of the following
Colour Blindness
Heart Conditions
Asthma or Respiratory Issues
Hearing Impairments
Mobility Issues or Physical Disabilities
Mental Health Conditions (e.g., anxiety, depression)
Allergies (please specify)
Vision Impairments
Epilepsy or Seizure Disorders
Diabetes
Do you have any dietary restrictions or preferences that we should be aware of?
Yes (please specify)
No
Do you have a criminal record?
Yes (please specify)
No
Have you had any previous injuries or surgeries that may impact your participation in physical activities?
Yes (please specify)
No
Do you have any specific learning needs or disabilities?
Yes (please specify)
No
Do you require any special accommodations for your learning (e.g., additional time, specific learning aids)?
Yes (please specify)
No
Please specify any information required
Emergency Contact
Parent/Guardian Name
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How did you hear about us?
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Chris - Bars2you
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