Liberties Training Centre Application Form
Please read the course descriptions on the website carefully before completing the form.
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Name: *
Address: *
How did you hear about us? *
Phone Number: *
To confirm your eligibility, we will need the following information. PPS Number: *
Date of Birth *
Are you in receipt of any social welfare payment, e.g. jobseekers, disability etc? Note: If you are over 18, you must make claim Jobseeker's Benefit/ Allowance from Social Welfare before you can start. This so you a receive a training allowance from us. *
What is your highest level of qualification? *
If you are under 18 years of age, please confirm your parent/ guardian’s details. Name:
Phone number:
Course(s) for which you are applying: *
Data Protection Statement: I am aware that data provided about my application and registration for a course with Liberties Training Centre will be forwarded to the Education Training Board (ETB). I consent to have information submitted to the ETB by hard copy or by electronic means for consideration. I am also aware that this information may be exchanged with other Government Departments / Agencies in accordance with the law. *
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