AM2 Resit Booking Form - Preston College

Application submitted by*

Submitter's email*

This will be used to confirm your application

Enter Email Confirm Email

Candidate details

Candidate Name*

First Last

ULN (if known)

Date of Birth*

National Insurance Number

Contact Number*

Candidate Email*

Enter Email Confirm Email

Address*

Street Address City Post Code

Emergency Contact

First name Last name

Relationship to individual

Contact number

Was the candidate born outside the UK?*

Yes
No

If yes, where?*

Does the candidate have a learning difficulty, disability or medical condition that affects your learning?*

Yes
No

Please specify details of learning difficulty, disability or medical condition (including details of EHCP if applicable).*

Employment Status

How long has the candidate been with their current employer/been self employed?

How many hours do they work per week?

How long have they currently been without employment?

What benefit are they currently receiving?

Assessment Type

Please select the type of Assessment*

Resit of sections

Select any number of sections

Payment to be made by*

Candidate
Employer
Training Provider

Training Provider

Check if this is a JTL booking
Check if this is a Bury College booking
Check if this is a XS Training booking
Check if this is a Burnley College booking
Check if this is a Carlisle College booking
Check if this is a Kendal College booking

Preferred Assessment Start Date

Training Provider

Training Providers

Check if this is a JTL booking
Check if this is a Bury College booking
Check if this is a XS Training booking
Check if this is a Burnley College booking
Check if this is a Carlisle College booking
Check if this is a Kendal College booking

Name of Training Provider*

Contact Name*

Contact Number*

Contact Email*

Enter Email Confirm Email

Address*

For invoice if required

Street Address City Post Code

PO Number (if known)

Employer Details

Employers

Check if this is a Chris Bowker booking

Name of Company*

Contact Name*

Contact Number*

Contact Email*

Address*

For invoice if required

Street Address City Post Code

PO Number (if known)

This field is hidden when viewing the form

Evidence

Attach Evidence

Attach evidence to support your application here

Drop files here or

Accepted file types: jpg, jpeg, gif, png, pdf, Max. file size: 50 MB, Max. files: 10.

Attach candidate photo

Max. file size: 10 MB.

What is your ethnicity?

Additional information

Let's Keep in Touch

Aside from your application, from time to time we would like to send you marketing information about our courses, offers, products and services. If you agree to be contact in this way, please select your preferences below:

Email
SMS
Phone
Post

Privacy Notice – How we use your information.

The personal information you provide is held by Preston College and is stored on the College’s computerised record system for the current academic year and a further academic year, in line with the General Data Protection Regulations (GDPR).

Where necessary it is also shared with the Department for Education, including Education and Skills Funding Agency, to meet statutory responsibilities, included under the Apprenticeships, Skills, Children and Learning Act 2009.

If you have applied for an Apprenticeship, your data may also be shared with employers advertising vacancies in the local area, who the College will ensure are GDPR compliant.

If you require any further information about how your data will be used, please contact the Data Protection Officer by email.

Enquiries

For all types of AM2 assessment enquiries please email am2@preston.ac.uk