Home
About Cirque
Alternative Provision
Blogs
Curriculum
Find Out More
Schools / Local Authority
Students
Parents
Pamper Parties
Contact
Legal
Home
About Cirque
Alternative Provision
Blogs
Curriculum
Find Out More
Schools / Local Authority
Students
Parents
Pamper Parties
Contact
Legal
Form
Curriculum >
Introduction to Teaching and Supporting Home Learning
1. Personal Details
Have you been on a course with APCL in the last year?
*
Yes
No
Course Title
*
Title
*
Mr
Mrs
Miss
Other
First Names:
*
Surname:
*
Date of Birth
*
DD slash MM slash YYYY
Address
*
Postcode
*
Contact number
*
Email
*
Gender
*
Male
Female
Transgender
Other
Country of domicile
*
(The country you have lived for the last 3 years)
2. Household Situation
Household Situation
*
No household member is in employment, and the household includes one or more dependent children
No household member is in employment, and the household does not include any dependent children
I live in a single adult household (employed or unemployed) with one or more dependent children
None of the above statements apply
Prefer not to answer
3. Qualifications
Qualifications
*
No previous qualifications
Entry Level (qualifications below level 1)
Any other qualifications below level 1
Level 1 (CSE, maths or English grade D or below)
Full Level 2 (5 GCSEs, 1st Diploma, or equivalent)
Full Level 3 (A-Levels, A2 + AS, L3 Diploma)
Level 4 (Year 1 Degree/Foundation Degree, HNC)
Level 5 (Year 2 Degree, Foundation Degree, HND)
Level 6 (Degree, BA, BSC, etc)
Level 7 (Master’s Degree, MA, MSC, etc)
Any other qualifications (level not known)
4. Emergency Contact
Emergency contact name
*
Relationship to you
*
Emergency contact number
*
5. Employment Status (A, B, C or D)
On the day before the course were you:
*
A) in paid employment
B) I am not in paid employment
C) I am not in paid employment and not looking for work
D) I am self-employed
How long in employment?
*
Up to 3 months
4 to 6 months
7 to 12 months
More than 1 year
How long unemployed
*
Less than 6 months
6 to 11 months
12 to 23 months
24 to 35 months
More than 3 years
Do you receive any of the following benefits
I receive JSA
I receive ESA
I receive Universal credit
Other
6. Ethnicity
Do you consider yourself:
*
English/Welsh/Scottish/N Irish/British
Irish
Gypsy or Irish Traveller
Any other white background
White and Black Caribbean
White and Black African
White and Asian
Any other mixed/multiple ethnic background
Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background
African
Caribbean
Any other Black/African/Caribbean background
Arab
Any other ethnic group
7. Residential Status
I have been resident in the UK/EU for the last 3 years?
*
Yes
No
How did you arrive?
*
Refugee
Right of abode
Asylum seeker
Leave to enter/remain
Other
8. Where did you hear about the course?
Please tick
*
From an IAG Officer
From a tutor (this may be from a previous course you attended)
From the venue where the course is being held
From the Job Centre Plus
From the Internet, Facebook or any other Social Media source
From One Stop in Doncaster Council
From a friend / relative
Other
9. Learning Difficulties, Disabilities & Health Problems
Do you have any disabilities or health problems you would like to make us aware of?
*
Yes
No
please specify
*
Do you have any learning difficulties you would like to make us aware of?
*
Yes
No
please specify
*
In an emergency evacuation do you need any assistance in leaving the building?
*
Yes
No
If you have answered YES to any of Q9 your tutor will discuss this with you in more detail
10. Family Learning Courses Only
Please complete this section for every child attending the course with you:
Child’s name (first and surname)
Year group
Age
Add
Remove
11. ESOL & AEB Learning Aims Only (tutor to check)
Please confirm the following details if enrolled on above aims
I earn less than £16,009.50
Yes
No
12. Why do AFCL ask so many questions?
The Education & Skills Funding Agency (ESFA) and European Social Fund (ESF) fund our courses, as a condition of this funding we have to supply them with your information. It helps us to ensure that we are allocating our funding correctly
13. Privacy Notice
How We Use Your Personal Information This privacy notice is issued on behalf of the Education and Skills Funding Agency (ESFA), on behalf of the Secretary of State for the Department of Education (DfE) to inform you (the learner) how your personal information will be used by the DfE, the ESFA (an executive agency of the DfE) and any successor bodies to these organisations. For the purposes of relevant Data Protection legislation, the DfE is the data controller for personal data processed by the ESFA. Your personal information is used by the DfE to exercise its functions and to meet its statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009 and to create and maintain a unique learner number (ULN) and a personal learning record (PLR). Your information will be securely destroyed after it is no longer required for these purposes. Your information may be shared with third parties for education, training, employment and well-being related purposes, including for research. This will only take place where the law allows it and the sharing is in compliance with the Data Protection legislation. The English European Social Fund (ESF) Managing Authority (or agents acting on its behalf) may contact you in order for them to carry out research and evaluation to inform the effectiveness of training. This contact could be from the AFCL Service, or partners acting on their behalf in accordance with Data Protection legislation, to assess your learning experience and progression onto further learning opportunities. Further information about use of and access to your personal data, and details of organisations with whom we regularly share data, are available at: information about how long we retain your data, and how to change your consent to being contacted, please visit: https://www.gov.uk/government/publications/esfa-privacy-notice
You can choose to agree to be contacted for other purposes. Please tick the following;
I agree to be contacted about future courses
I agree to be contacted for surveys and research
I agree to be contacted by post
I agree to be contacted by phone
I agree to be contacted by email
14. Learner Declaration
I have received the necessary information and confirm that the course suits my needs. I agree to enrol on the above course and to take an active part in learning. I have read and agree to the privacy statement set out above and agree to the collection and processing of the data on this form for the purpose stated.
Learner signature
*
Date
*
Day
Month
Year
15. Upload ID
File
*
Max. file size: 50 MB.
CAPTCHA
