PATH TRAINING 2011

Fill in one application form per applicant. Make more copies as necessary
Name of applicant ………………………………………………………………………………
Member of staff o Volunteero Trusteeo Othero
Project……………………………………………..…………………………………………………
Contact Address……………………………………………………………………………………
Telephone Contact…………………………….…………………………………………………
Email Address……………………………….………………………………………………………
Learning Support
PATH has a range of resource to support your learning please indicate below any additional needs you have or any support you would like us to provide to help you when attending our training (if you would prefer to discuss these with a member of staff please contact Suzannah at the PATH office)
……………………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………………
Managers Confirmation (if necessary)
Managers name……………………………………………………………………………………
Managers Signature……………………..………………………………………………………
Training course applying for: (please tick the relevant box)
Using Fire with Children 21st January 2011
Surviving the Winter Blues 4th February
Child Protection Briefing date tbc
Cancellation
Once PATH have confirmed your booking your training place is secure. Individuals who do not turn up to the training, without at least 24 hours prior notice, will be charged £20 for non attendance.
Return completed applications to Majeda Begum: PATH, Oxford House, Derbyshire St,London E2 6HG.

Equal Opportunities Monitoring Form

It is PATH’s policy to monitor all applications to help ensure training procedures meet our equal opportunities policy. The form is separated from the application and is used for monitoring purposes only. Please return it with your booking form

Training Course Applied For:
Male/Female:
Date of Birth:
Ethnic Origin
I would describe my ethnic origin as (please circle as appropriate):
a. Black-Caribbean b. Black-African c. Black Other
d. Indian e. Pakistani f. Bangladeshi
g. Chinese h. White i. Other (specify)
Do you consider yourself to have a disability? YES/NO
If you are registered disabled, please state your number.
Registration No:

Thank you for your assistance.

WORKING TOGETHER FOR PLAY

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