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Personal Details


Title
First Name

This should be your legal name. This will then be used for all our communications, official documents (e.g. certificates), and correspondence.

Surname

Date of Birth

Click here to view a guide on entering your date of birth using a calendar.

Sex

Please enter as stated on your birth certificate or other legal documents

National Insurance Number

Home Address

Address Line 1
Address Line 2
Town / City
County

Postcode

Previous Postcode


Mobile Number
Telephone number
Email Address
Email Address (enter again)
     

Ethnicity

Ethnic Group

Residency

Have you been legally resident in the UK for the last 3 years?
Is Home Fees

Please note that if you have not been a legal resident in the UK for 3 years, we need to collect more information from you to determine eligibility. Please answer the questions below which will be reviewed prior to your enrolment being accepted

Country of Permanent Residence

Date of Entry into the UK

Residency Status

Supporting you in your learning

Do you consider yourself to have a disability and/or learning difficulty

Learning difficulty question

Please specify primary learning difficulty

And, if appropriate, a secondary learning difficulty

Do you feel this has the potential to affect your learning?

ALS Requested

Do you have an Education, Health and Care Plan (EHCP)?

Has Education Health Care Plan





Prior Attainment


What is the highest level of qualification you have achieved?

 Click here to view the Enrolment Qualifications Guide

Employment Status

What is your current employment status?

How many hours per week?
How long have you been employed?

Are you self employed?

Is Self Employed
How long have you been unemployed, not looking for work and/or not available to start work?

Remission Reason

The field below will be mandatory if you have claimed a remission on the first page

Choose your type of benefits, if none apply please leave blank

Supporting Evidence

Please upload evidence if your remission reason is one of the following:
To evidence your eligibility:
Option Evidence to Upload
Earn below the £25,000 annual gross salary earnings threshold Please upload evidence of your gross annual wages. This could include a wage slip, UC statement dated within 3 months of your learning start date, or a current employment contract which states gross wages.
Work for Cumberland Council or Westmorland and Furness Council Please upload proof of employment with Cumberland Council and Westmorland and Furness Council.
Type of Evidence
Notes
Upload File

Type of Evidence Notes Attachment Remove
No attachments uploaded yet

Are you attending any other publicly funded training?

How did you hear about us?
InEd

Discount Code

NOTE: discount codes are not applicable when you have already added a fee remission

Enter your discount code below and click 'check code' to apply your discount

Discount code

Privacy Notice

All details on this form are subject to the terms of relevant data protection legislation. Information supplied by you will be retained in accordance with retention periods and used for statistical and monitoring purposes. By signing this form, you agree to share your data with Adult Learning and relevant government departments including the Education and Skills Funding Agency and the Learner Records Service (LRS) to fulfil our statutory obligations.
To improve our provision, you may be contacted during your learning and/or after you have completed your provision(s) to participate in surveys aimed at evaluating the quality of provision and to assess learner progression. In addition to this, I agree to be contacted about future learning opportunities with Adult Learning.


Please tick to agree

At no time will your personal information be passed to other organisations for marketing or sales purposes

Learner Declaration

I confirm that the details I have provided on this form are correct and that I have correctly identified my highest level of qualification and the remission for which I am eligible, if applicable. I declare that I fulfil the residency criteria set out by the Education Skills Funding Agency. I understand that my enrolment(s) are subsidised or fully funded by public funding and if I have declared false information, Adult Learning may take action to reclaim fees.
For accredited provision, I confirm that I have provided accurate personal details for registration with awarding bodies and agree to attend examinations when required.
I confirm that I wish to proceed with my enrolment and accept that upon submitting this form I will be issued with a copy of the associated Learning Agreement by email containing the ‘Individual Learner Record’ and ‘Learning Records Service’ privacy notices for my review before electronically signing my enrolment form.