VTCT BT3C7 CERTIFICATE IN SKIN CAMOUFLAGE

COURSE APPLICATION/REGISTRATION

Email to:

Course No:

Location:The Squire Centre, 33-37 University Street, London WC1E 6JN

YOUR DETAILS:

First Name: / Date of Birth:
Surname: / Country of Origin:
Telephone no: / Address:
Street:
Town:
City:......
Post code:
Mobile no:
E-mail address:
Emergency Contact Details:
Name:
E-mail / Land line Tel:
Mobile:
If you already hold a VTCT certificate
VTCT No: / Other qualifications
Course title
1.
2.
COURSE PROGRAMME:
The course is accredited by VTCT (Vocational Training Charitable Trust) and consists of three elements: Pre-Course Study, a 3 day Practical Course and a portfolio of evidence (including exam). Certificates are issued after the candidate has completed all elements and passed the exam and the portfolios are assessed by a VTCT assessor and verified by a VTCT the IQA.
Tea and coffee is provided but lunch is not provided, (we are very close to many shops and restaurants)
Do you have any other needs/requirements it would be useful for us to know about?
______
The Pre-course Study Pack will be send to you via email 3 weeks before the course, the practical course will take place over 3 days, each day will start at 9am and finish at approximately 5:30pm. Days 1 and 2 will consist of practical training and on day 3 you will be observed working on clients. The clients attending will know that this is a training event. The trainer, an experienced practitioner, will support you and give you feedback throughout the course stages.
WORKWEAR: Please bring with you suitable workwear e.g. a tunic or tabard.
TRAVEL & ACCOMMODATION:
Travel and accommodation is not included in the course fee. Please make your own arrangements if accommodation is necessary. (We often use the Travelodge, Premier Inn or Ibishotels at Euston Station as they are only 8 minutes’ walk to The Squire Centre. The nearest tubes stations are Warren Street and Euston Square).

Data Protection:

The Data Protection Act requires us to ask for your consent to record information about you beyond basic details. You can request to view the information we hold on you. It will not be passed on to any third parties.

Do you consent for the personal information requested on this document to be recorded on our database?

Delete as appropriate: Yes / No

If no, we would be grateful if you would give us the reason for this choice:

Answer:______

As you have expressed an interest in our work we will keep your contact details on our database so we can send you updates on our services of relevance to your professional discipline.

PAYMENT:

VTCT BT3C7 Level 3 Certificate in Cosmetic Camouflage.

The fee for this course is £699 per candidate and the fee for the kit is £520: Total £1219.00 (A kit could be shared in your work venue if you are training more than one candidate for a department)

Acceptance on the course is conditional on receipt of the full fee paid prior to the first day of the course. Deposit £175 required on confirmation of your place on the course. Places are limited.

Cancellation policy: If you cancel more than 4 weeks in advance of the practical course date we will reimburse 50% of the fee. If you cancel within 4 weeks of the course the full fee is payable. If the course is cancelled by Changing Faces your fee will be refunded in full.

Please tick one of the following three methods of payment:

□Number of candidates□ Number of kits

□ ON-LINE BANKING (Banking information will be emailed to you on confirmation of your place on the course)

□ CHEQUEI enclose a cheque for £………….. payable to Changing Faces □ CREDIT / DEBIT CARD

Name of cardholder (name on card)

Address of cardholder:

SignatureDate

For NHS professionals – we can reserve your place on receipt of an official purchase order number.
□ INVOICE
Official purchase order number from your institution: ______

Name, organisation and address to which the invoice should be sent:

Organisation:
Address:
Post Code:

Office use only

Deposit received
Payment received

Skin Camouflage Confidentiality Agreement

This agreement applies to all trainees involved with Changing Faces Skin Camouflage Training who are attending observed consultations and are also being observed as part of their training. In each consultation the Skin Camouflage Administrator will check with the client whether they are happy to be seen by a trainee skin camouflage practitioner and trainer.

The Skin Camouflage Service offers a personalised service to individuals and as part of this service, confidential and personal information relating to each individual is discussed.

No identifying information about a client should be given directly or indirectly to anyone outside Changing Faces unless the client has been asked for and has given consent except in very exceptional circumstances where there is concern about potentially serious risk to an individual or to another person. No other person outside Changing Faces should ever know that a client has contacted the Charity, except in exceptional circumstances e.g. you are concerned for their safety.

If a trainee has breached the confidentiality policy it may not be possible for them to continue training with Changing Faces.

My signature signifies I agree to these terms and will abide by, adhere to and honour all of the above. Those returning this form by email should type “returned by email” in place of a signature to show they are willing to abide by this agreement.

______

Signature of TraineeDate

Print Name: ______

This agreement is not intended to be a legally binding contract or intends any employment relationship to be created either now or at any time in the future.