BOOKING FORM

Social Care & Fostering Courses open to external organisations

Please complete one form per course, and per applicant.

*Please state your email address clearly as joining instructions & confirmation will be sent to this email address:

Name: / Organisation:
Date: / Job Role:
Charging Type: / Private and profit making ☐ / Public Sector ☐ / Voluntary and Non-profit making ☐
Email:
Delegate contact details: / Address 1
Address 2
Address 3
County
Postcode
Work telephone:
Mobile number:

*Please state if you require any reasonable adjustments to be made to attend the training. E.g visual, hearing or access needs.*If yes please confirm details below:

Details:
Sector:
*please indicate with an ‘X’ / Health ☐ / Police ☐ / Education ☐ / Armed Forces ☐
District/ ☐
Borough
Council / Department ☐
for Works
and Pensions / Early Years ☐
And Childcare / Essex ☐
Probation
Service
Voluntary ☐
Community
Sector / Private Voluntary ☐
Independent / Local Authorities ☐ / Other ☐
*Please specify

*Please indicate if the billing address differs from the contact details above:

Email:
*Billing address : / Contact name
Department
Address 1
Address 2
Address 3
County
Postcode
Work telephone:
Mobile number:

Course details

Course title:
Course Date:
(Choice 1) / Venue:
Course Date:
(Choice 2) / Venue:

Line Manager’s Endorsement and Verification

Line Manager’s name: / Signature:
Email Address: / Telephone Number
I endorse this application and verify that the application reflects the individual’s personal development plan.

Guidance

Charges:All courses are payable upfront, a minimum of 6 weeks prior to the chosen course date. Non or late payment will result in cancelling the booking. Delegates will not be permitted to join the course if they are not listed on the register of attendance, which will be reconciled against payment details.
Course charges:
Private and profit making Organisations / £75 per course
Public Sector / £50 per course
Voluntary and Non-profit making organisations / £25 per course
Bookings:Courses open to extendedorganisations are identified within the training programme. To apply, please complete one booking form per course, per person and return to the email or postal address below.
Confirmation of your place and joining instructions will be emailed out within 2 working weeks of the course date by Essex Brokerage services. If you do not receive joining instructions, this indicates a place has not been secured.
Fostering courses can be accessed by Fostering agencies, local authorisations etc. and enquiries can be made via this booking form to the email address below.
Cancellation:The fee is non-refundable. Should you be unable to attend a course on which you are booked, please notify us as soon as possible. Your place will then be transferred to an alternative course date. Delegates who fail to attend without prior notice, will not be entitled to transfer their booking.
Data Protection: Essex County Council will process your personal information given in this document in accordance with the Data Protection Act 1998. ECC will not disclose this information to any unauthorised persons and this information will be retained securely. The Council may also use this data in connection with the prevention or detection of fraud or crime.
Contact us:
Partner agencies - enquiries regarding your booking can be made to Essex Brokerage Services on 01245 434396 or email
Fostering Training – enquiries regarding your booking can be made to Fostering Training on 01245 435610 or email:
Please return your completed booking form to the applicable address:
For Partner Agencies return to:
Essex County Council
Essex Brokerage Services
A8 County Hall
Market Road
Chelmsford
Essex
CM1 1QH / Fostering Training return to:
Essex County Council
Fostering Training Team
E2 County Hall
Market Road
Chelmsford
Essex
CM1 1QH

For internal use only

Action / Date
Essex Brokerage Service/ESCA to add the booking to LMS ☐
Essex Brokerage Service forwarded the booking form to ESCA (if applicable) ☐
Invoice raised by ESCA team☐
Payment received ☐
Ensure Essex Brokerage Service are informed payment has been received (if applicable)☐
Essex Brokerage /ESCA to update LMS, send booking confirmation/joining instructions ☐