Individual Development Activity

  • Before you complete this form please ensure that you haveagreed this development activity with your line manager.
  • Please complete the form with full details of the proposed activity with the organisational and individual learning objectives identified.
  • Your manager should approve the training by either adding an electronic signature ortyping their name and then emailing it to . This will verify that the applicant has the support of their line manager.
  • Any ASC21’s received without signatures and/or not directly received from the manager will be returned.

Full Name of Applicant: / (please use capital letters)
Job Title:
Workbase Address: / (To ensure you receive confirmation of your booking, please state full address.)
Contact Telephone Number and E-mail address:

Development Activity – please attach copy of relevant details

Title:
Venue:
Date:
Training Provider Name & Address:

Development Activity Costs

Amount / Contribution from Social Care Learning & Development (for office use only)
Total Fees:

*Any travel, accommodation or subsistence costs will need to be met from the operational/organisational budget*

Please indicate the type of service you offer: / Please indicate the sector type of your
organisation:
Supporting people with learning disabilities
Supporting older people
Supporting people with physical disabilities
Other support / Statutory sector (e.g.: local authority or Health)
Private or Independent Sector (including not for profit)
Voluntary sector

Development Activity Content & Learning Objectives

Outline of content/ list of units preferred:
How will this learning support your work or continuing professional development and/or contribute greater personalisation of services?Please complete this section carefully as it will form an important part of the selection process.

Applicant signature: Date:

Line Manager Name: (Block capitals)

Line Manager Signature: Date:

The form should now be forwarded to the Social Care Learning and Development Manager for Budget Allocation:

Agreed: Yes/ No (please delete as appropriate)

Signed: (Social Care Learning

& Development Manager) Date:

Reason for Rejection:

If approved you are responsible for booking your own external course or conference.

If you require advice on payment for this activity please telephone 01872 323625.

For all other development activities a place will be allocated through Social Care Learning and Development.