QRT | powered by magn8 | Expression of Interest

Your Details

Title

Forename

Surname

Date Of Birth

Legal Sex

Address Search

Please type in your current address or current postcode in the field below to find your address details.

Address Line 1

Address Line 2

Town

Postcode *

Previous Postcodes since 2010: (*if different from current postcode)

Telephone Number

Email

Learning Records Service (LRS) Privacy Notice

Please ensure you read the separate Learning Records Service (LRS) Privacy notice given to you along with this form. * Your previous postcodes will be used to identify the correct learner record on the LRS portal where your information is similar to other learners. You may also find the latest version of the LRS privacy notice on their Website

Do you have a Level 2 or above Maths qualification equivalent to GCSE at grade C or 4 and above or functional skills level 2?

Yes

No

Residence Eligibility

Have you been living in the UK or an EEA country continuously for at least 3 years before your learning start date?

Yes

No

Are you one of the following: A UK national? OR An Irish national? An EEA national with pre-settled or settled status under the EU Settlement Scheme?

Yes

No

If you have answered ‘No’ to one of these questions, you will need to show us evidence of your residency status.

Which of the following closest describes your current residency status? *

What is your current immigration status? *

We require documented evidence of your status to proceed, please select and upload one of the document types below: *

Upload Document: *

What is the reference/identification number on the document? *

On what date was the document issued? *

What is the document Valid until/Expiry date? *

Due to the expiry date of your document, please select and upload one of the below documents showing application extension / administrative review /appeal has been submitted: *

Please add any further details about your evidence, include solicitor name, application/appeal reference etc.: *

Upload Document: *

Remarks shown on document:

Any further information?

Ethnicity

Select your ethnicity

Learning Difficulties, Disabilities and Health Problems

Do you consider yourself to have any disabilities, health problems or learning difficulties?

Qualifications - Please indicate the highest level of qualification you currently hold:

Current Employment Details - Please confirm your current employment status details:

Select your employment status

How many hours per week?

0 to 10 hours per week

11 to 20 hours per week

21 to 30 hours per week

31 hours per week or more

Are you Self-employed?

I am self-employed

I have been unemployed for:

Less than 6 months

6 – 11 months

12 – 23 months

24 – 35 months

36 months or more

Have you been made redundant?

I have been made redundant

Please indicate if you are currently in receipt of one of the following benefits:

Job seekers allowance BSI1

Employment & Support Allowance (ESA) BSI5

Universal credit BSI4

Other state benefit BSI6

If you have ticked one of these benefit boxes, please provide your National Insurance number (2 letters, 6 numbers, 1 letter):

Education And Skills Funding Agency (ESFA) Privacy Notice

Please ensure you read the separate Education and Skills Funding Agency (ESFA) privacy notice given to you along with this form. You may also find the latest version of the ESFA privacy notice on their website:

https://www.gov.uk/government/publications/privacy-notice-for-key-stage-5-and-adult-education/privacy-notice-for-key-stage-5-and-adult-education

CLS Marketing, Research and Profiling Permissions:

Please ✔ the boxes if you wish to be contacted by us in the future:

About courses, learning opportunities and relevant promotional offers

For research, profiling, and quality improvement purposes

Please indicate your CLS contact preferences:

Email

Post

Phone

Text

The CLS privacy notice can be found on our website at:

https://www.kentadulteducation.co.uk/privacy-policy/

Individual Learner Agreement Form

Complete Your Details Now.