Enrolment Form

/Enrolment Form
Enrolment Form2018-11-21T16:58:32+00:00

1.1 Emergency Contact Details

2. Ethnic Origin - How would you best describe yourself?

31. White British32. White Irish34. White Other35. Mixed - White and Black Caribbean36. Mixed White and Black African37.Mixed White and Asian38. Mixed any other mixed background39. Indian40. Pakistan41. Bangladeshi42. Chinese43. Asian Other44. Black African45. Black Caribbean46. Black Other98. Other

3. Nationality

Note: If you haven’t always resided in the UK we will need to see your passport at enrolment

4. DISABILITIES & LEARNING DIFFICULTIES

YesNo

YesNo

4.1 If you have more than one learning difficulty and/or disability please state which is your primary;

4. Visual impairment5. Hearing impairment6. Disability affecting mobility7. Profound complex disabilities8. Social and emotional difficulties9. Mental health difficulty10. Moderate learning difficulty11. Severe learning difficulty12. Dyslexia13. Dyscalculia14. Autism spectrum disorder15. Asperger's syndrome16. Temporary disability after illness17. Speech, language and communication needs93. Other physical disability94. Other specific learning difficulty95. Other medical condition96. Other learning difficulty97. Other disabilities98. Prefer not to say

5. PRIOR ATTAINMENT LEVEL

Levels Examples Y
No Previous Qualifications I have no previous Qualifications
Entry Level Word power, number power.
Certificate in adult numeracy,
certificate in adult literacy
I have Entry Level Qualifications
Level 1 5 or more GCSE grade D – G or
less that 5 GCSE grade A* - C
I have Level 1 Qualifications
Full Level 2 5 or more GCSE grade A*- C,
NVQ Level 2
I have Full Level 2 Qualifications
Full Level 3 2 or more A levels, 4 or more
AS levels, NVQ Level 3
I have Full Level 3 Qualifications
Level 4 Certificate or higher degree
(HNC), Level 4 NVQ
I have Level 4 Qualifications
Level 5 Foundation degree (HND) or
Level 5 NVQ
I have Level 5 Qualifications
Level 6 Bachelors degree I have Level 6 Qualifications
Level 7 Masters degree I have Level 7 Qualifications
Other qualifications / Not known I have Other qualifications / Not known

5.1 PRIOR ATTAINMENT ENGLISH & MATHS

Levels English Maths
GCSE X or U or
no previous
qualifications
Functional skills
entry level
Functional skills
entry level 2
Functional skills
entry level 3
Functional skill
level 1*
Functional skills
Level 2
GCSE E-G
GSCE D
GCSE GCSE A* - C

*Please note when enrolling onto an apprenticeship programme the requirement for functional skills will be discussed in more detail
however if you are exempt from your Level 1 functional skills elements and this is a requirement for the course
completion ESP will support your development should you wish to complete your Functional Skills Level 2;

I have exemptions for my level 1 functional skills elements and wish to complete my Level 2’s

I have exemptions for my level 1 functional skills elements and do not wish to complete my level 2’s

6. HOUSEHOLD SITUATION

01. No household member is in employment and the household includes one or more dependant children

02. No household member is in employment and the household does not include any dependant children

03. Learner lives in a single adult household and with dependant children

98. Prefer not to say

99. None of the HHS1 , HHS2, or HHS3 applies

6.1 YOUR EMPLOYMENT/EDUCATION STATUS PRIOR TO STARTING YOUR COURSE

a. Employed

Up to 3 months

4-6 months

7-12 months

12+ Months

b. Employed

0-10 Hours Per Week

11-20 Hours Per Week

21-30 Hours Per Week

31+ Hours Per Week

a. Unemployed

Less than 6 Months

6-11 months

12-23 months

24-35 Months

Over 36 Months

b. Unemployed

In receipt of JSA

In receipt ESA

Other benefits

Universal credit

a. Other

Full-time education or training

Self employed

Other (please state)

7. YOUR CHOICE OF COURSE

This section will be filled in automatically

Please confirm whether you are applying for;

AEB

Advanced Apprenticeship

Intermediate Apprenticeship

Higher Level Apprenticeship

8. Employment details

9a. SELF-DECLARATION – ADULT EDUCATION BUDGET ONLY

I am enrolling on a Level 2 or below qualification and am undertaking this course to assist my entry in to employment. I am currently in receipt of;

OR

I am enrolling on my first full Level 3 qualification, do not currently hold a qualification at Level 3 or above and was a member of the British Armed Forces within the last 10 years and one of the following applies to me (please tick;)

OR

9b. SELF-DECLARATION – LEARNERS IN PAID EMPLOYMENT AND IN RECIEPT OF A LOW WAGE

As of the new academic year learners in receipt of a low wage may be entitled to the full amount of funding for a programme if the below
applies;

I confirm that the above statement is true;


10. PAYMENT BY EMPLOYER – NON LEVY FUNDED LEARNERS ONLY

As part of the new Levy funding guidelines 01/05/2017, if you are a non levy paying employer you will share the cost of training and
assessment with the government, this is called “co-investment”, you (the employer) will pay 10% towards the cost of training while the
government will pay the remaining 90% up to the maximum funding band (for more information please visit
https://www.gov.uk/government/publications/apprenticeship-levy-how-it-will-work/apprenticeship-levy-how-it-will-work#non-levy-payingemployers)

SAFEGUARDING CHILDREN, YOUNG PEOPLE AND VULNERABLE ADULTS

ESP is keen to support all students to help them succeed. For some careers you will need to declare all criminal convictions including
those that are spent. We ask that you declare all unspent criminal convictions, doing this will not necessarily stop you being offered a
place on the course.
If you are unsure on what to declare then please seek advice from our student advisor or ask a careers advisor at the national careers
service at https://nationalcareersservice.direct.gov.uk.

YesNo

If you have declared that you have an unspent criminal conviction you will receive a letter with an attached form. You will have 10 days
to return the form to ESP who will review your disclosure and will inform you of any actions we may take. They may ask you to come in
for an interview to further discuss your disclosure. Please note that failing to complete this section or providing false information may
lead to your application/enrolment being withdrawn.

Please click here and read the Learner Agreement

You can opt in to contact by the ESP & ESFA by ticking any of the following boxes; I wish to be contacted by the following methods;

New Courses - Surveys & Research
By PostBy EmailBy Phone

Learning Opportunities - Surveys & Research
By PostBy EmailBy Phone

LEARNER DECLARATION

I confirm that the details I have given on all sides of this form are correct. I have received enough information about the courses(s) for which
I am enrolling to make an informed choice and I am aware of the range or support that is available to help my learning


How did you hear about our courses?

Course Guide
Leaflet
Local Newspaper
Website
Radio
Event
Outdoor Banner
School
Word of mouth
Social Media
Other

GDPR STATEMENT FOR ALL ESP LEARNERS

**Highly Important Please Read and Confirm**

All your personal data is held securely by ESP.

DATA PROTECTION & YOUR PERSONAL INFORMATION – How we use your personal information

By providing ESP with your information you consent to us holding and processing the information as set out in our registration. As part of audit
and compliance ESP may be required to share your details with third parties however ESP will ensure that we comply with the general data
protection regulation at all times. It will also be used by the Education and Skills Funding Agency (ESFA) an exclusive agency of the department
for education (DFE) for statistical analysis and to issue you with a unique learner number (ULN), and to create your personal learning record.
For more information about how your information is processed and shared refer to the extended privacy notices on Gov.uk

Https://www.gov.uk/government/publications/lrs-privacy-notices
Https://www.gov.uk/government/publications/sfa-privacy-notices

Your data will be treated confidentially and will not be disclosed to external organisations, other than those acting as agents for ESP on related
projects or for other legitimate reasons. ESP will process data about you for a variety of purposes including all aspects of the administration of
your learning. This will include your data being used to produce statistics to show educational trends and inform Ofsted.

We will not give out data about you to third parties except when you ask us to or when ESP is under a legal requirement to provide
information. This means, for example, that we will pass some information to partners with whom we work in collaboration, to government
departments, funding councils, representatives of these bodies such as auditors, and to those administrators as appropriate.

We will not release data to anyone who is unauthorised. If you wish your data to be released in such circumstances you must consent to this.
This means that we will not release data to banks, friends, relatives etc without your agreement.

It is your responsibility to inform us if the data we hold about you requires updating. You must notify us immediately if your personal data
changes - for example, your address. In addition, we will provide periodic opportunities for you to check your data through a printout of all the
information stored within our administrative systems and databases.

ESP will retain your records after you have completed your learning in line with your Awarding Organisation’s requirements.

You are entitled to request a copy of the data we hold about you. You are also entitled to raise an objection where the processing of data we
hold about you is likely to cause damage or distress (subject to provisions contained in the Data Protection Act 1998). Requests should be made
in writing to Simon Quilter in the first instance.

APPRENTICESHIP AGREEMENT

Further to the Apprenticeships (Form of Apprenticeship Agreement) Regulations which came into force on 6th April 2012, an Apprenticeship
Agreement is required at the commencement of an Apprenticeship for all new apprentices who start on or after that date.
The purpose of the Apprenticeship Agreement is to:-

  • Identify the skill, trade or occupation for which the apprentice is being trained;
  • and confirm the qualifying Apprenticeship framework that the apprentice is following.

The Apprenticeship Agreement is incorporated into and does not replace the written statement of particulars issued to the individual in
accordance with the requirements of the Employment Rights Act 1996.
The Apprenticeship is to be treated as being a contract of service not a contract of Apprenticeship.

Apprenticeship Particulars:





Signatories:

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