The Information you supply on this form will be treated in confidence
SECTION TWO QUALIFICATIONS
Qualifications Work related
SECTION 3 WORKING ACTIVITIES/EXPERIENCE (please include any work experience and/or voluntary work)
Name and Address of Employer:
Dates from and to:
SECTION 4 PERSONAL DETAILS
Do you have any health issues which might affect your learning? YesNo
Do you have and additional needs which could affect your learning? YesNo
Are you involved with any agencies who are supporting your access to learning?YesNo
For individuals under 25 only:
Household Situation (please tick the statement which describes you the best):
No member of the household in which I live (including myself) is employed
The household that I live in includes only one adult (age 18 or over)
There are one or more dependent children (aged 0-17 years or 18-24 years if full time student or inactive) in the household
None of these statements apply
I confirm that I wish to withhold this information
SECTION 5 EQUALITY AND DIVERSITY MONITORING
CONFIRMATION OF ELIGIBILITY
To benefit from government funding to support your learning programme Rocket Training needs you to confirm your eligibility. Please tick the boxes below which apply to you.
Confirm that you have completed year 11 and are older than the legal school leaving age.
Confirm that you are not attending any other course including Higher Education.
Confirm that you are a citizen of the European Economic area.
Confirm that you have the right to work in England.
Confirm that you have status to live in the UK if you are a refugee and/or asylum seeker.
I confirm that the information above is correct.
If the Applicant is under the age of 16, a Parent / Guardian must sign to give consent for the applicants data to be processed.
We may collect additional reports and information to verify information supplied on this application and to support your application, where the law allows it .