Trainingapplication form
Course information– Please complete a separate form for each course.
Course Title: / Foundation Level E-learning course
Course Date: / within 24 hours from applying / Date Applied:
Personal details
Name:(Please print)
Job Title:(Do not abbreviate)
Work address:
Organisation / Service Area:
Phone number: / Email:
Do you have any additional requirements such as wheelchair access?
Managers details – Applications will not be accepted unless this section is completed
Name: (Please print)
Job Title:
Work address:
Phone number:
Email:
Once completed, please return this form and the Equal Opportunities form (page 2) to the Lewisham Safeguarding Children Board via email:
OR
By posting it to: Lewisham Safeguarding Children Board, 4th Floor Kaleidoscope Centre for CYP, 32 Rushey Green, Catford, London, SE6 4JF
Equal Opportunities monitoring formDo you wish to complete this form?
Yes / No
Please indicate your ethnic origin (this information will be treated in strict confidence)
White / Black
British / British
Irish / Caribbean
Other White background / African
Other Black background
Asian
Asian British / Mixed parentage
Indian / White & Black Caribbean
Pakistani / White & Black African
Bangladeshi / White & Asian
Tamil / Other mixed background
Other Asian background
Chinese or other background
Chinese / Turkish
Vietnamese / Turkish Cypriot
Other ethnic origin
Please indicate your agency
Children and Young People / Youth Services
Early Years / Education (not including schools)
School / Housing
YOS / Lewisham Healthcare NHS Trust
CAMHS / SLAM / Metropolitan Police
Probation / Lewisham Council other
Other (please specify)
Faith group / organisation / / If you are a member of a faith, voluntary or private agency, please also answer the two questions below marked * to help us monitor organisation attendance
Private / voluntary organisation
* Does your organisation operate on a not-for-profit basis? / Yes / No
* Is your organisation a registered charity? / Yes / No