PICS Learner Management System : Applicant Sign Up : All About Me - Enquiry Form (Young Adult Learning Programme)

All About Me - Enquiry Form (Young Adult Learning Programme)

If you need assistance filling in this form please contact your tutor. Otherwise contact Business Support on 01905 728537 or adultlearning@worcestershire.gov.uk.

What is your preferred start date? *

What area or areas are you interested in? *

Hairdressing
Beauty
Childcare
Teaching Assistant
Business Administration
Skills for Employment and Personal Development
Other

If you chose other, please tell us more

How did you hear about us? *

Please complete this form with as many details as you can for the young person who wants more information about how we could support them.

All this information will be needed for us to match them up with the best course. If you need help to complete this form, the Young Adult team can be contacted on 01905 728537.

This is not a formal application - it just provides us with the information we need to help you decide whether you want to apply. You will be asked whether you want to formally apply after we have spoken to you.

If you would like to formalise your application immediately, please call us.

Young Person's Details

First Name *

Preferred Name

Surname *

Date of Birth *

Please state your gender, as written on a form of legal ID, e.g. Birth Certificate/ID card/passport/driving licence *

What gender do you identify as? (optional)

Preferred Pronouns (optional)

What is your ethnicity? *

Have you been living in the UK or EU country for the last 3 years? *

Are you an Asylum Seeker, Refugee or on Indefinite Leave to Remain? *

Where do you live?

House Name/Number and Street Address *

Address Line 2

Town/City *

County *

Postcode *

What are your contact details?

Email *

Home Tel No.

Mobile No. *

Your support network

Please give us your legal guardian's details first:

Parent/Carer Name *

Parent/Carer Relationship (e.g. mother/father/grandparent/guardian) *

Parent/Carer Phone Number *

Parent/Carer Email Address *

If there is someone else you'd like us to contact, please put their details here:

Parent/Carer Name

Parent/Carer Relationship (e.g. mother/father/grandparent/guardian/social worker)

Contact number

Email Address

Please tell us who you would prefer for us to contact first, and any other details that think we need to know about your family situation

Education

Last School Attended *

Year of leaving *

Any College or Training Provider attended since leaving school:

College / Training Provider (1)

Course

Date started

Date ended

Outcome

Reason for leaving

College / Training Provider (2)

Course

Date started

Date ended

Outcome

Reason for leaving

Qualifications Achieved to Date

GCSE English Grade *

GCSE Maths Grade *

If you are waiting for results, or have not taken GCSEs yet, please choose NONE and select from the menu:

Additional Support

Do you consider yourself to have a long term disability, health problems or learning difficulty? *

If yes, please select all that apply. If no, please select 'none' *

What is your primary long term disability, health problem or learning difficulty? If none, please select 'none' *

Do you have an EHCP? *

If you have an Education, Health and Care Plan (EHCP), do you give permission for us to obtain a copy? *

If you have an EHCP, please give us the full name of your caseworker:

Are you a Looked After Child or Care leaver? *

Are you engaging with any support agencies? *

If you have any support worker, please put their name here:

Employment Status - please answer all that apply

Employment Status *

If you answered 'In employment' please answer the following question:

How many hours do you work per week (on average)?

Let us know if you are claiming any of the following benefits. Please leave blank if you are not claiming benefits, or your benefit is not listed.

Privacy Notice 2024/25

Learner data is collected by Worcestershire County Council, the data controller, in accordance with the terms and conditions of funding imposed on providers of learning by the Education Skills Funding Agency.

Your personal information is used by Worcestershire County Council to exercise its functions and to meet its contractual and statutory responsibilities, together with the Education Skills Funding Agency (ESFA) to create and maintain a personal learning record (PLR). Your information will be securely destroyed after it is no longer required for these and audit purposes. This would normally be 6 years from the April after your course finishes, unless the funding supporting your course requires a longer retention period. In these cases, we will let the individual know the length of retention.

Your information will be used to contact you about the course for which you have applied and may also be shared internally and with third parties, for education (including exam boards e.g. and assessment providers, e.g. BKSB), training, bursary (e.g. EdenRed) employment and well-being (safeguarding) related purposes, including for research. This will only take place where the law allows it and the sharing is in compliance with data protection legislation. We use Pellcomp (PICSWeb) for our management of information. Please see their privacy pages for further information: Pellcomp Privacy Statement

To comply with data protection legislation, we are responsible for issuing a copy of the Learning Records Service privacy notice to learners. This notice summarises the information held on record about them, why it is held and the third parties with whom the data may be shared. Please open the link: ILR Privacy Notice 2024 to 2025 version 1 January 2024 (submit-learner-data.service.gov.uk) which will open in a new window. By clicking submit, you confirm that you have read the privacy notice.

For further information please see our privacy pages: Information use and privacy statements | Worcestershire County Council

By signing up for our courses you also grant permission for us to (potentially) use some of your course work for positive promotional purposes. This may include use on social media, in print, and used for display purposes. Where possible, course work may be credited to the learner, however this may not be possible in all circumstances. Please inform your course tutor if you do not wish your name to be used.

By clicking ‘submit’, you confirm that you have read this privacy policy in full and the ILR Privacy Notice 2024-2025. You also declare that the details you have entered about yourself and your course, are accurate and true.

Submit

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