account details page Islington Adult Community Learning

Asterisks '*' indicate fields that must be completed.

Key

Title

Forename

Surname

Date of birth

Address

Postcode

Line 1

Line 2

Town

Personal

Mobile

Landline

Gender

Female
Male

Ethnicity

Emergency contact name

Emergency contact telephone number

National Insurance Number

Are you a UK national?

What is your nationality?

Do you have permission to live in the UK for 12+ months?

What date did you enter the UK?

Do you have settled or pre-settled status?

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

Provide more information, e.g. if you chosen 'Other' for immigration type

Is English your first language?

What is your first language?

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

Are you a parent/carer of children (under 19 years old)?

What is youngest age (in years) of your children?

Do you care for an adult and in receipt of a carers allowance?

Do you have regular access to a PC, laptop or tablet to help with your learning?

Do you have a reliable internet connection?

Learning Support

Do you consider yourself to have a disability, learning difficulty or medical 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?

Further information

Do wish to speak to someone about support needs?

PEEP required

Employment status

What is your employment status?

Are you also self employed?

How long have you been out of work?

How many hours are you employed for?

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

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

Previous qualifications

Prior attainmentPlease select your highest level of previous qualification

Last time in learning

Using Internet

Using Email

Using Word Processing

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 Islington Adult Community Learning

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 following boxes.

About courses or learning opportunities

For surveys and research

By post

By phone

By email

I have read and understood the

What is your main reason for joining this course?