Web.Enrol enquiry page East Berkshire Community Learning and Skills Service

<p>Please complete the fields below and submit to make an enquiry.</p>

Key

Title

supportContactMobile

Forename(s)

Surname

Date of Birth

Address

Postcode

Address Line 1

Address Line 2

Town/City

Personal

Mobile Phone No,

Gender

Female
Male

Do you have a desktop/laptop computer at home for use with your learning?

Contact Phone No.

Ethnicity

Emergency Contact Name

Telephone Number for the Emergency Contact

National Insurance Number

What is your first language?

What date did you enter the UK?

Do you look after a child under 18 years of age?

Is English your first language?

Do you have a working Internet connection at home?

Have you lived in the UK/EEA/Switzerland for the previous 3 years?

Do you have a settled / pre-settled status in the UK under the EUSS scheme?

What is your youngest childs age (in years)?

What is your nationality?

Are you a UK national/citizen?

Do you care for an adult family/friend with a disability/illness?

Do you consider that any of these apply to you? (please tick any options that apply)

What type of immigration permission do you have in the UK?

If other please specify

Learning Support

Do you consider yourself to have a disability, learning difficulty or mental health issue?

Yes
No
Prefer not to say

Do You Have Any Learning Support Needs? (please tick)any options that apply)

Which of the above will have the most significant impact on your learning?

Any additional comments?

Request discussion on disability support?

PEEP required

Employment status

Please state if you are in receipt of one the following benefits:

What is your employment status?

How many hours are you employed for?

How long have you been unemployed for?

Were you in full-time education or training immediately before you joined this course?

Are you self employed?

Previous qualifications

Prior attainmentPlease select your highest level of previous qualification

highest english GCSE grade

highest maths GCSE grade

How would your rate your confidence with using the Internet?

How would your rate your confidence in using emails?

Please provide details of this government funded training

Are you undertaking any other government funded training in this academic year?

Other

Where did you hear about us?

I have read and understood the

Contacting you

Tick here to be included in our mailing list for news about courses and events at CLASS

Your information may be used for education, training, employment and well-being related purposes, including for research, ourselves and the Department for Education or their agencies may contact you in order for them to carry out research and evaluation to inform the effectiveness of training.

You can agree to be contacted by other third parties by ticking any of the relevant boxes on your course application form.

About courses or learning opportunities

For surveys and research

By post

By phone

By email

Please explain why you would like to do this course.

A member of our team will get in touch with you either by phone or email.