Online Course Training Application Form

All of the information provided will be used and stored by N&B Training Company Ltd in accordance with our Data Protection Registration.

Section 1 - Personal Details

NEXT OF KIN (Please provide details of your next of kin)

Section 2 - Eligibility

(In order to attract full funding, several eligibility criteria must be met, please answer below)

Have you been a resident in the UK/EU for the last three years, prior to the start of the course? YesNo
Have you left compulsory education? YesNo
Are you in higher education? YesNo
Are you on any other government funded programme? YesNo
If you have ticked ‘No’ to any of the FIRST two questions or ‘Yes’ to the LAST two questions, please speak to a representative at N&B Training before proceeding.

Section 3 - Equal Opportunities Monitoring

Please select an option to identify your ethnic origin:

Is English your second language?: YesNo
If you answered ‘yes’ to the above, what is your preferred language?

Section 4 - Household Situation

Please tick which of the following statements apply (one or more may apply):

No member of the household in which I live (including myself) is employedThe household that I live in includes only one adult (aged 18 or over)There are one or more dependent children (aged 0-17 years or 18-24 if full time student or inactive) in the householdNone of these statements apply to meI wish to withhold this information

Section 5 - Prior Attainment

Please complete the fields below:
Maths Level

NoneEntry LevelFunctional Skills / Key Skills

GCSE GSE O Level

English Level

NoneEntry LevelFunctional Skills / Key Skills

GCSE GSE O Level

Highest level of qualification previously achieved:
Qualification name: Level:

Section 6 - Health

(This section will be dealt with in the strictest confidence)

We aim to ensure that you are sufficiently supported through all aspects of your qualification and in order to do this effectively, we ask that you let us know of any known health concerns and/or disabilities. Please read through the list first and then tick appropriately:

AllergiesAsperger’s SyndromeAsthmaConfined spacesDiabetesDisability affecting mobilityEczemaEmotional/Behaviour disabilityEpilepsyFainting / black outsHearing impairmentHeightsLiftingMental health difficultyMigraines / headachesMultiple disabilitiesProfound complex disabilitySpeechTemporary disability after illnessVisual impairmentOther physical disabilityOtherNot knownPrefer not to sayNone

Section 7 - Your Aims

Course Applying for:


Please tell us why you would like to do the course:

Section 8 - Additional Support

We aim to ensure that you are sufficiently supported through all aspects of your qualification and in order to do this effectively, we ask that you let us know of any known learning difficulties. Please read through the list first and then tick appropriately.

Autism Spectrum DisorderDyscalculiaDyslexiaModerate learning difficultyMultiple learning difficultySevere learning difficultyOtherNo learning difficulty

Section 9 - Employment

Are you currently employed? YesNo

If "yes", please confirm how long you have been with your current company for?:

Are you currently receiving state benefits? YesNo

If "yes", please specify which benefits you are claiming?:

Are you actively seeking employment? YesNo


Section 10 - Declaration

The information you supply will be used by the Skills Funding Agency, an Executive Agency of the Department of Business, Innovation and Skills, to issue you with a Unique Learning Number (ULN), and to create your Personal Learning Record. For details about how your information is processed and shared, refer to the Extended Privacy Notice available on Gov.UK.

I understand and agree that my personal data is going to be used for processing my application and for the completion of my qualification. YesNo

Learner's signature

THANK YOU FOR COMPLETING THIS APPLICATION.

This form will now be processed and subject to successful diagnostic testing, your application will be put forward for funding approval. Please note funding is subject to the Government eligibility criteria being met and verified.