Total Training Provision

Learner Information
First Name:*
Surname:*
Previous name (if known by any other):
Postcode*
DOB*
DD slash MM slash YYYY
Gender*
- Male
- Female
- Other
National Insurance Number:*
Telephone Number:*
Email Address:*
Were you aged 19 or above on the 31st August 2020
- Yes
- No
Are you an Armed Forces Veteran?
- Yes
- No
Qualification / Course applying for*
- Apprenticeship
- Blended Learning Course**
- Employability
- Forging Ahead
- Traineeship / Study Programme
- **All our blended learning qualifications are delivered online with 121 and tutor support. You will receive access to your online learning portal, once your paperwork has been processed and following the successful completion of your enrolment onto the course of your choice. If you wish to complete the distance learning course via a paper-based workbook then please tick

Employer Information (For employed learners only, leave blank if not applicable)
Company Name
Company Address
Company Postcode
Managers Name
Managers Contact Number and Email

Learning style

Please tell us your preferred learning style if known
Learning style
- Visual (Prefer to see and visualise)
- Auditory (Prefer to hear rather then read)
- Reading/Writing (working with text)
- Kinaesthetic (Hands on learn by doing)
Programme or course you are applying for:*
Do you have any prior knowledge or learning in this area?
- Yes
- No
If yes: please detail
Do you require any additional support to complete the programme/course
- Yes
- No
If yes: what support is necessary?

Learner confirmation

I have been given course information and feel this course will meet my learning needs
Learner Signature
Print name
Date
DD slash MM slash YYYY

Application Form