Learner Eligibility and Enrolment Form

This registration form collects all the information we need to register you at the College. If you find it difficult to fill in, please ask for help. You will receive confirmation of your Registration and Learning Agreement once we have processed this form. This activity is part-financed by the European Union through the European Social Fund (ESF). ESF supports activities to extend employment opportunities and develop a skilled workforce. If any of your personal details change, please email: learnertracking@preston.ac.uk

Section 1 About You

Please give us your full legal name

1. Last name(Required)

2. Forename(Required)

If you have previously been known by a different name, please give details

3. Middle name(s)

Other (please specify)

6. Date of birth(Required)

7. Age at 1st September 2020(Required)

Please enter a number from 10 to 100.

8. Preferred last name (if different)

9. Preferred forename (if different)

10. What is your National Insurance Number?(Required)

Start date at this address

Tel:

Mobile:

Email:

12. Household Situation
Please provide details of your household situation, if you would prefer not to say, please leave blank.

Number of adults in household

Number of employed adults in household

Number of dependent children in the household

13. Safeguarding
The college has a legal duty to safeguard all its learners and to provide a safe and secure learning environment for them to study and achieve their potential. In order to do this we need to be aware of any potential risk so that it can be assessed and managed appropriately. We therefore require all prospective learners to answer the following question prior to enrolment.

If your answer is Yes, you should not disclose any further details to the person enrolling you. This information will be passed to the Designated Safeguarding Officer, who will contact you to discuss the issue before your enrolment can proceed. Any information that you then disclose will be treated with the utmost confidentiality and only shared with others on a strictly need to know basis. If it is deemed necessary to share your information, you will be kept informed of the person(s) it is shared with and why

What is your ethnic group?

Choose one option that best describes your ethnic group or background.

24. If no, what was your date of entry into the UK or EU?

My learner number is

Other (please specify)

28. What is your place of birth?

Please state the UK town or city, or if born outside the UK, the country of birth