Intro To Community Organising (for 16- 24) March 17, 2018
Please fill in this application form which will take about 10 minutes and will help us to have some basic information so that we can:
-Get you CERTA certificate which officially counts as CPD (Continued Professional Development)
-Get to know who you are and why you are attending so that we can tailor the experience
-Gather monitoring data which will help us to understand who is benefiting from this program and report to our funders
-Know who to contact in case of an emergency.

THERE ARE ONLY 20 SPACES AVAILABLE
WE WILL NOTIFY YOU BY THE 16TH OF MARCH IF YOUR APPLICATION HAS BEEN SUCCESSFUL

Whilst the purpose of this program is to inspire and support social action, you can join this session with no strings attached!

Your data will be stored safely and only used for purposes stated on this document.
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Name (as you would like it to appear on your certificate) *
Address *
City *
Postcode *
Telephone/ Mobile
Email *
How do you prefer to be contacted? (email, phone call, text, post, other - please state)
Please tell us a little bit about yourself and why you interested in our training program? *
What do you hope to get out of the session? *
How did you hear about this training?
Please provide an emergency contact including name, relationship and contact details (If you are under 18 please provide your parents/ legal guardian details) *
We are committed to equal opportunities as a training provider and in order to find out how well we are achieving with this we need to collect monitoring data. This monitoring form is voluntary but the information we collect here is very useful to us as it helps us to make sure that we are an inclusive training organisation and to find out if our learner participation is diverse. The information you supply on this form will be kept confidentially. The monitoring form is not sent to the Awarding Body but is used by us and by COLtd to improve our recruitment practice.
Age
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Gender (M/F/T/Not stated)
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Sexuality (Gay/heterosexual/bisexual/not stated)
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Ethnicity
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Religion
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Do you have any disabilities or learning difficulties we should know about? If the answer is yes, please give us more details
What are your dietary requirements?
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Do you have any allergies?
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Is there anything else you would like us to know about you?
Are you happy to be openly copied into emails including other participants?
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Consent. *
Required
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