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Course enquiry form - WKCIC/SFAIf you would like further information on this programme, please complete the form below and we will contact you shortly with more information Which programme(s) are you interested in? Aged 19+ adult vocational skills training 18-24 NEETs Project 16-24 Year old young people with learning difficulties and /or disabilities Your details Name * Your address * Postcode * Borough * Main contact telephone number * e-mail address * Date of Birth *DD 01020304050607080910111213141516171819202122232425262728293031 MM 010203040506070809101112 YYYY 2012 2011 2010 2009 2008 2007 2006 200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916 Gender *MaleFemale Do you have the right to work in the UK? *YesNo Are you currently unemployed *YesNo If 'yes', how long have you been unemployed If you are currently unemployed, what type of benefits are you receiving? Job Seeker’s Allowance Employment Support Allowance Income Support None Other If ‘Other’ please specify Do you have a disability or health condition *YesNo If 'Yes', please give details How did you hear about the Learning Centre? * Please indicate your ethnic origin? *White-British ChineseWhite-Irish Black/Black British-CaribbeanWhite-Other Black/Black British-AfricanWhite – Turkish / Turkish Cypriot Black/Black British-OtherWhite – Greek / Greek Cypriot Mixed- White & Black CaribbeanWhite - Kurdish Mixed - White & Black AfricanAsian/Asian British-Indian Mixed- White & AsianAsian/ Asian British-Pakistani Mixed - OtherAsian/ Asian British-Bangladeshi Asian / Asian British – East African Asian Prefer Not to SayAsian/ Asian British-Other A diverse range of people Other If Other please specify
If you would like further information on this programme, please complete the form below and we will contact you shortly with more information
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