Participant Enrolment Form

The Mayor of London and the Greater London Authority (GLA) are committed to investing in free adult skills courses to empower Londoners with the tools they need to thrive in a rapidly changing job market.

Please use this form to express an interest to sign up to a fully funded course and we will call you to talk through suitable options, or feel free to contact us directly.

We are supporting the following programmes:

Adult Skills Fund | London Multiply Programme | Social Care Academy Hub | Health Hub

Best wishes,

Urooj Khan | integratedcaresupport.com

hello@integratedcaresupport.com

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* 1. Participant Details

Full Name

Postcode

Borough

Contact Number

Date of Birth

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* 2. Gender

Male

Female

Other

Prefer not to say

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* 3. Please let us know if you fall into any of these priority areas?

Care leaver

Adult caring responsibilities

Ex-offender or experience of the criminal justice system

None of the above

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* 4. What is your current employment status?

Out of work - looking for work

Out of work - not looking for work

Employed

Studying

Please feel free to provide further details.

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* 5. What is your highest level of education?

Below primary education

Primary education or equivalent

Lower secondary education or equivalent

Upper secondary education or equivalent

Post-secondary education or equivalent

Higher education or equivalent

Not known

None

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* 6. Have you achieved a Level 2 (or equivalent of GCSE A-C/grade 4) in Maths and English?

Yes

If 'No', please provide more details.

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* 7. What is your qualification achieved in English?

Pre-entry (School / 6th Form / FE College)

Entry 1

Entry 2

Entry 3

Level 1 (GCSE Grade D-G/Grade 3,2,1 / Level 1 Diploma / Level 1 Certificate)

Level 2 (GCSE Grade *A-C/Grade 9,8,7,6,5,4 / Level 2 Diploma / Level 2 Certificate)

Unknown

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* 8. Under the definition of the 2010 Equality Act, do you consider yourself to be disabled?

Yes

Prefer not to say

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* 9. How would you describe your ethnic origin?

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* 10. Are there any barriers that have prevented you from accessing adult education to date. If none please enter N/A.

These might include but not limited to:
Childcare, low income, disability or health conditions, confidence (especially for maths/numeracy learning), negative experience of learning (especially for maths/numeracy learning), awareness of opportunities, homeless, ex-offenders.

Barrier 1

Barrier 2

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* 11. If you have identified any barriers, are they related to numeracy?

Yes

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* 12. Finally, we'd love to hear how we connected with you. Please let us know how you heard about our support.

Via our website

At an event

During a bite size training session

From a healthcare professional

From a friend

Via a one-to-one conversation

Via a voluntary and/or community organisation

From a volunteer or community worker

Via the DWP (Department of Work & Pensions)

From a college/Further Education (FE) college

From a jobs/recruitment agency

From an information session/meeting

Social media

Via care leaver newsletter

Other (please specify)

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* 13. Privacy Notice and Declarations
I confirm:

The information provided in this Participant Enrolment Form is correct and accurate to the best of my knowledge

I will inform you if there is a change in my circumstances which may affect my eligibility between now and the day I start

I am aware that my details will be processed by Integrated Care Support Services on behalf of the GLA and passed onto local training providers in order to process this application

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* 14. I confirm I have read and agree to the GLA Privacy Notice (here) and give my consent to share my details with the Greater London Authority (GLA).

Name

Signature

Date

Participant Enrolment Form

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* 1. Participant Details

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* 2. Gender

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* 3. Please let us know if you fall into any of these priority areas?

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* 4. What is your current employment status?

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* 5. What is your highest level of education?

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* 6. Have you achieved a Level 2 (or equivalent of GCSE A-C/grade 4) in Maths and English?

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* 7. What is your qualification achieved in English?

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* 8. Under the definition of the 2010 Equality Act, do you consider yourself to be disabled?

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* 9. How would you describe your ethnic origin?

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* 11. If you have identified any barriers, are they related to numeracy?

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* 12. Finally, we'd love to hear how we connected with you. Please let us know how you heard about our support.

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* 13. Privacy Notice and DeclarationsI confirm:

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* 14. I confirm I have read and agree to the GLA Privacy Notice (here) and give my consent to share my details with the Greater London Authority (GLA).

* 13. Privacy Notice and Declarations
I confirm: