Section 1

Name:

Job title:

Correspondence address:

Postcode Tel: Email:

Section 2 - Please tell us which 2 day training event from the 2015-16 or 2016-17 National Short Course Programme you have already attended

OR which course you intend to attend from the 2017-18 National Short Course Programme

Course title and date:

For office use only: Course code

Section 3 - Acceptance onto the Award in STH will only be given if the following prerequisites are met.

·  Please provide details and dates of the most recent learning course and /or academic qualification that required you to complete an assignment.

·  What previous academic qualification do you have (last 3 or highest level)?

·  What level of academia or work experience in health, social care or education provision do you have?

·  What level of academia, work or leisure experience in horticulture or gardening do you have?

·  Do you have the ability and access to use the Internet and word process?

Thrive reserves the right to decline a request if these prerequisites are not met. However, guidance will be given on how to meet them if your application is unsuccessful. Successful applicants will be sent a payment form and further details of how to proceed with the Award.

Section 4

What do you hope to gain from this course?

Section 5

Do you have any mobility requirements, learning support needs or is there any other support needs you would like us to know about? Do you require any information in an accessible format?

How did you find out about the Award in STH?

£ Thrive postal promotion £ Thrive e-mail promotion £ Thrive website £ Thrive course

£ Coventry University £ Coventry Uni Website £ Internet search £ Article (where)

£ Web link (which one)

Equality and Diversity (Equality Act 2010)
Thrive is committed to the principle of equal opportunities for all. A full copy of our Equality Policy is available on request. To enable us to monitor the implementation of this policy, we would be grateful if you would answer the following questions.

How old are you?

Please tick where appropriate: Age
16-24 / 25-34 / 35-44 / 45-54 / 55-64 / 65+
/ Gender
M / F
Which of the following most closely describes your cultural origin?
UK black / African-Caribbean / Asian
UK white / European (other than UK) white / Irish
African / European (other than UK) black / Other (please describe below)
Do you consider yourself to have a disability? / Yes / No

The information you provide on these forms will be put on Thrive’s National Database. We will only use this information to evaluate the course and to help plan future training days. If you agree to the above statement please tick this box ð

Disclaimer

The information I have provided is accurate to the best of my knowledge – please sign below.

Signature: Date:

Terms and conditions

At Thrive we respect your privacy and would assure you that Thrive fully complies with the Data Protection Act (1998). Occasionally we like to swap personal contact details with like-minded organisations. If you would prefer not to receive this communication please tick this box£

For office use only

Agreed start date / Pre course option / Post course option / Tutorial / Support needs
Academic level / Additional supporting information needed
Study support – Signpost study skills publications/web / Short written piece

Please wait until your application has been accepted before sending payment

Updated Jan 14

EXPECTATION AND STUDENT RESPONSIBILITIES

Learning agreement

Students are requested to read and sign this learning agreement at the start of the Award (which is supplied with the pre course pack).

This is a standard quality measure that we have adopted to ensure:

·  Students understand, and have clarity of expectations from Thrive.

·  Students understand, and have clarity of expectations of themselves.

Under this agreement we will ensure that:

1.  You receive information, advice and guidance about the Award.

2.  You receive the appropriate Award handbook, handouts packs and have access to other relevant information.

3.  The programme is delivered by suitably qualified and effective members of staff in a healthy and safe environment.

4.  You have access to adequate learning resources to learn successfully.

5.  Your progress is reviewed during the course (tutorials).

6.  You will have support for any specific learning needs you may have

7.  You will have the opportunity to contribute to the Award Review and Evaluation Process.

8.  Your rights as defined by the Equality Act 2010 will be protected and respected.

9.  You are aware of the Complaints Procedure, which outlines the steps to be taken if you feel that this agreement is not being fulfilled (obtainable from Thrive).

10.  At Thrive, we respect your privacy and would assure you that Thrive fully complies with the Data Protection Act (1998).

Your part in this agreement is to accept responsibility for the following:

1.  The Award may involve contact with other students in simulated scenarios. We expect therefore that you will act in a reasonable fashion with the due consideration that you would expect from others.

2.  That you will initiate any requests for support through the outlined route identified within the Award handbook under support.

3.  To undertake sufficient private study to maintain progress on your learning programme.

4.  To attend all elements of your learning programme punctually.

5.  To respect the individual rights of all other students, staff members, volunteers, vulnerable adults and children on site, and to behave according to our Equality Policy in regard to their ethnic background, gender, age or sexual orientation. Including individual rights of privacy and confidentiality.

6.  To comply with all Health and Safety regulations.

7.  To respect Thrive’s environment and adhere to the Smoking Policy of each venue.

8.  To accept that if any of the above conditions are not satisfied you may be requested to leave the course.

I confirm that to the best of my knowledge, the information given in this form is correct and complete, and that I have read and understood the terms and conditions and agree to abide by the conditions set out in them.

Signature: Date:

Please make sure you discuss your place on the Award with a member of the training and education team if you have not already. For any other queries relating to the Award or any other part of the Thrive training and education programme on T: 0118 988 5688 or E:

Please return your signed application to:

Thrive, The Geoffrey Udall Centre, Beech Hill, Reading, RG7 2AT