Application form for LOPD Courses 2016-17
Please use this form to make a booking for one of our Live Online Professional Development (LOPD) courses. Once you have submitted a booking you will receive a confirmation email from one of our team (please note this is not automated and will be sent when the booking has been processed) If you wish to book more than one course then you will be required to submit this form for each course.

Please ensure that all the requested information on this application form is provided. It is preferable that individual applicants complete this form and this form is not submitted on their behalf however if you are booking this course for a colleague and not for yourself then please ensure that the applicant is aware that you have made the booking and that all information provided on their behalf is complete and correct.

Title
First name of course participant
Your answer
Last name of course participant
Your answer
Live Online Professional Development course
Please select from the list of courses below. If your chosen course is NOT listed then either the course is already fully booked and closed for bookings or the course is not yet open for booking. If this is the case, please let us know that you would like to be notified when your chosen course is next open for bookings by submitting details on our 'expression of interest form' here: http://bit.ly/LOPD-EOI-2016-17.
Email address of person attending
Please ensure that your email address is entered accurately and you have supplied an email address that you use regularly. ALL course information is sent via email. It is important that this email address is the address of the course participant and that the participant is aware that this address may be visible to others in the course group.
Your answer
Contact telephone number
We will typically contact you via email however it would be useful to have a contact telephone number for you too.
Your answer
How did you find out about this online course?
Which A level exam specification(s) is most relevant to you
Required
Have you participated in an LOPD course before?
It would be useful to know if you are familiar with Blackboard Collaborate, our online classroom system, and whether you already have an LOPD Integral username, even if it has expired.
LOPD username
If you have a username from a previous or concurrent LOPD course, please state it here. You do NOT need to give your password.
Your answer
Please select your main reason(s) for enrolling on this online course
Please select at most three.
Required
Please detail below (briefly) any relevant teaching experience to date:
e.g. taught C1 and C2 for two years but have not taught applied modules before
Your answer
Invoicing
To process your application we will need some additional details from you, including your home and school address (if applicable). If your school requires a purchase order number then it is important that you provide this information below.
Required
Purchase order number (if applicable)
If you indicated above that your school requires a purchase order number please provide it here.
Your answer
The course fee is
The course fee is detailed on the course flyer. The fee is £195 for a longer course (6 sessions or more) and £95 for a shorter course (up to 5 sessions). Invoices will be issued approximately one week before the published start date of the course. Please only select a code if you have been asked to do so, otherwise you should select the appropriate course fee. When gaining agreement for the funding for your course, please remember that you may also need to purchase a headset and/or graphics tablet in order to access the sessions fully. See course flyers for further details.
School / College Name
Please state the full name of the school or college where you work. If you are not currently working at a school or college then just enter your home postcode here instead and again below
Your answer
School / College address
It would be helpful if you could provide us with this information. If your school is paying your fees then this information is required along with the name and department of the person to whom the invoice should be sent.
Your answer
School / College postcode
Your answer
Home address including postcode
If you are paying the fees yourself then please supply your home address This address will be used to send you the invoice.
Your answer
Terms and conditions agreement
I have read the details of the course and understand the commitment expected. I understand that all live sessions are recorded and these recordings will be available to all participants. However, I understand that if I am unable to attend some or all of the live sessions then the full course fee is still chargeable and I may not be eligible for an attendance certificate. I acknowledge that the advertised session dates may be subject to change. I acknowledge that the course may be cancelled if under-subscribed and under these circumstances any fees paid will be returned in full. I understand that I may cancel my place provided I do so BEFORE the first online introductory session and if I wish to exercise this right of cancellation I need to send an email confirmation to LOPD@furthermaths.org.uk. I acknowledge that no refund will be made if I cancel my place on the course AFTER the first online introductory session and any unpaid course fees will still be chargeable. I acknowledge that my place cannot be transferred to another participant.
Required
Please detail below any additional information that is relevant to your booking/application
Please use this space to tell us anything we might need to know regarding your booking or attendance, for example, if you already know that you will need to miss a session, please give the date here, or if you have any special needs relevant to your accessing the course, please let us know how we can best support you. If your query requires a response, please instead contact LOPD@furthermaths.org.uk.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms
Google Forms