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If you would like to enrol on any of our courses please complete the on-line application form below. As soon as we receive this we will contact you and let you know how to access your course. To qualify for a funded course you will need to complete a short initial assessment. This can be done at our Sunderland Centre, at home or even at work. Please call us for details: (0191) 566 0978

Enrolment Form

Personal Details:

Surname:		Forename(s):
D.O.B:		Home Tel No:
Address:		Work Tel No:
		Mobile No:
Postcode:		Where did you hear about Learndirect?
Email:

Additonal Information:

Have you previously been on a Learndirect course?			Yes No
If Yes what is your username?
Have you completed any learning in the past three years?			Yes No Don't Know
What is your employment/economic status?

	Employed Full Time		Retired
	Employed Part Time		In further/higher education
	Self Employed		Looking after family at home
	Registered Unemployed		Grovernment Training Programme

Learners Information:

What do you consider your ethnic background to be?

Please tick which of these statements applies to you:
	Considered to have learning difficulty
	Not considered to have learning difficulty
	Not prepared to disclose information
Do you consider yourself to have a learning difficulty?
	No		Other specific learning difficulty
	Moderate learning difficulty		Multiples of learning difficulties
	Severe learning difficulty		Other
	Dyslexia		Prefer not to say
	Dyscalculia
Do you consider yourself to have a disability?
	No		Other physical disability
	Visual impairment		Emotional/ behavioural difficulty
	Disability affecting mobility		Temporary disability
	Other medical condition		Multiple disabilities
	Mental ill health		Other
	Profound complex disabilities		Prefer not to state
	Hearing impairment
Do you feel you need support for any of the above?			Yes No

Course and Learning Information:

What is your highest qualification to date? (e.g. O-Levels, GCSE, NVQ, Diploma etc.)
	No Qualifications		NVQ level 4 (equiv to 1st degree)
	Qualifications below level 1		NVQ level 5 (post graduate)
	Fewer than 5 GCSEs grades A-C		Other qualification, level not known
	NVQ level 2 (5 GCSEs grades A-C)		Not known
	NVQ level 3 (2 or more A levels)

Course Details:
The course(s) detailed below relate to my Individual Learning Plan which I have discussed with my learning provider. We have agreed that this course/these courses are most relevant to my learning goals.
Course Title:
Course Code:
Fee (To be paid by learner):
Start Date:
Planned End Date (agreed with learner):

Fee Payment :

How will you be paying your fees?
	I am paying my own fee		My employer should be invoiced
	My training provider is to be invoiced		I receive one of the benefits below
	I am aged 16-18 years		The course is free of charge
	The course is ESOL
Do you receive any of the following?
	Jobseekers Allowance		Housing Benefit
	Income Support		Council Tax Benefit
	Working Families Tax Credit		Disabled Persons Tax Credit
	I am unwaged dependent of someone in receipt of one or more of the benefits above
	I agree to inform my learning centre of any change of circumstances regarding benefit
Is your employer helping you with your learning?
	My employer is releasing me for my learning
	My employer is not releasing for my learning but is supporting me
	My employer is providing this training
	None of the above
What is your occupation?
Which sector do you work in?

Your Learning Goals:
Your learning provider will negotiate a learning goal with you so that you and your tutor know what you are aiming to achieve by completing your chosen course. Use the space below to give details of your learning goal.


Declaration:

I confirm that, to the best of my knowledge, the information given in this form is correct and complete. I agree to Learndirect processing data contained in this form, or any other data relevant to my learning or my health and safety whilst on these premises. I understand that Learndirect operates under the principles of the Data Protection Act 1998, and that information on this form will be passed to the learning and Skills Council and other educational organisations who are registered under the Data Protection Act 1998. Their registration is primarily for the collection and analysis of statistical data. In fulfilling its duties, Learndirect needs to share your data with other specified organisations, e.g the Learning and Skills Council. I have received appropriate information, advice and guidance about my chosen course(s) and their suitability for me. I agree to engage with my learning provider/tutor for the purpose of feedback and support.
I agree with the declaration above:			* Yes I agree
From time to time your information may be used by our partner organisations to gain feedback on our services.			Yes No
		*You must agree with the dedlaration above before you can submit this form

The Keyboard A-Z (KAZ)

They say the best things in life are simple - and KAZ is no exception. Statistics show that when people type they spend 99% of their time using the alphabet keys.

KAZ teaches you to touch type those 26 keys using just five sentences within a very short space of time. Once you've mastered those you can use the KAZ method of touch typing right away - and you've cracked it!

Around 1 million people are already using KAZ - large and small companies, schools, colleges and home users. Why not join them?