Certificate in Community Organising L2/L3 Registration Form
How exciting you want to take advantage of this great opportunity!
Community CoLab and Barton Hill Settlement's Bristol Social Action Hub would like to welcome you on board

PLEASE MAKE SURE YOU HAVE FULLY READ THE WEBSITE BEFORE REGISTERING to fully understand the time commitment. Ideally you would have already taken our intro to community organising, though we can make exceptions.

Face to face training dates 9-5pm:
June 20,21,24,25,26th (Take this dates only and complete 3 Units of assignments to receive An Award in Community Organising)
​July 1,2,3,4,5, 8,9,10, 29-31st
August 1,2,6,7,8th
You must attend at least 17 of the above 20 days and complete 9 units including 3 from Award in CO and Receive a Certificate in Community Organising.

Please fill in this form which will take about 10- 15 minutes and will help us to have some basic information so that we can:
-Get your information so that we can register you to receive your Award or Certificate in Community Organising from CERTA
-Get to know who you are, why you would like to sign up and provide any other information you deem important so that we can tailor your learning 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.

Your email will also be added to our mailing list.
Your data will be stored safely and only used for purposes stated on this document.
Name (as you would like it to appear on your certificate) *
Your answer
Last Name (as you would like it to appear on your certificate) *
Your answer
Employer or organisation if you belong to any and role
Your answer
Address *
Your answer
City *
Your answer
Postal code *
Your answer
Telephone/ Mobile *
Your answer
Email *
Your answer
How do you prefer to be contacted? (email, phone call, text, post, other - please state)
Have you attended our Introduction To Community Organising? *
Have you taken our 5 day Award in Community Organising? *
Are you planning to take: *
Are there any of the above dates you wont be able to make? You can only miss up to 1 of the first 5 days (Award in CO) or 3 of the 20 days (Certificate in CO)
Your answer
Please list any qualifications, training or relevant experience you already hold
Your answer
Tell us something about you, your experience, and your context which helps us understand what has led you to sign up for this course. *
Your answer
What do you hope to gain from the course? Where will you be applying your learning? *
Your answer
What are the questions you bring with you to this session about your work, your life or your community? *
Your answer
How did you hear about this training? *
Your answer
Pay As You Feel
The real running cost of this program is around 1K per participant for the full Certificate in CO training (including the Award in CO).
Whilst we have funds available to deliver this course, in order to sustain our work into the future and make this training accessible we are using a PAY AS YOU FEEL policy which means we trust you to decide how much you can contribute based on your needs and privilege following the guidelines from our website.

We don't want anyone to miss this opportunity, so don't be shy if you really can't contribute with money, there are other ways to contribute if your financial situation is tight, we welcome alternative offers from participants which help to enhance the experience, learning and connection potential, whilst putting to use your skills, knowledge and connections.

Any funds raised through participant payments will be reinvested into providing free or affordable training through The Bristol Social Action Hub in 2019
Please tell us how much you can pay. If you really aren't able to contribute towards the running cost, please let us know your circumstances, how else you could contribute and why this training is important to you. *
Your answer
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
Gender (M/F/T/Not stated)
Sexuality (Gay/heterosexual/bisexual/not stated)
Ethnicity
Religion
Do you have any disabilities or learning difficulties we should know about? If the answer is yes, please give us more details so we can tailor this experience for you.
Your answer
Is there anything else you would like us to know about you?
Your answer
Are you happy to be openly copied into emails including other participants? *
Consent. *
Required
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