booking form – Training centre courses.

Public Protection Service

V8.1 1804

Please complete Parts A and B of this form. Part C is for e-learning only

The information requested on this form will be used for course administration and to assist the Public Protection Service to develop its training services. We may also let you know about other Council services or seek your views about Council activities.

If you would prefer not to be contacted about our commercial services please tick this box:☐

PART A

Which course are you booking?

Courses are usually held at our Training Room, Building 4a, Derriford Business Park Plymouth PL6 5QZ
1st choice: Your course / event / Which date(s) would you prefer?
Preferred date: Click here to enter a date.
Alternative dates (dd/mm/yy) :Click here to enter text.
If other chosen: Click here to enter text. / For e-Learning only tell us how many licences you will need here> Click or tap here to enter text.Discounts will be applied on purchase. Candidate details can be added in Part C

Single candidate details here.For organisers booking one or more candidates please put your details below and the candidates requiring training on the next page.

* Your name
Title: Title / First name: Click here to enter text. / Last name: Click here to enter text.
Your address
House or flat number & street: Click here to enter text.
2nd line: Click here to enter text. / Town /City: Click here to enter text.
County: Click here to enter text. / Post code: Click here to enter text.
*Contact number: Click here to enter text. / *Email address: Click here to enter text.
*required field
Place of work or education (if applicable):
Name of business:Click here to enter text.
1st line:Click here to enter text. / Town /City:Click here to enter text.
County: Click here to enter text. / Post code: Click here to enter text.

Support we can offer

If you require any additional support relating to your training please let us know below, or contact our team on the number on the back of this form. We will call you to clarify how we can best help.

Click here to enter text.

How did you hear about our training and business services? Click here to enter text.

For group and additional candidates please provide details in the boxes below.

If any candidate requires support please provide details in the space on the previous page.

Title / First name / Last name / Date of Birth / Address and Post Code
Choose an item. / Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. /
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PART B

Please check the relevent boxes.

I haveread and understood thePPS Training terms and conditions☐

Payment method:

☐ / Debit/credit card—please call 01752 398501 between 09:00am and 05:00pm with your card details. If you would like to a call back please provide the bill payers name and number Click here to enter text.
☐ / Cheque (made payable to Plymouth City Council) with this booking form. Refunds due to cancellation beyond our control may incur a £17.00 charge.
☐ / PCC Internal Journal Transfer. Our LAFIS: 3708 8394Your LAFIS Code:Click here to enter text.

We will collect payment and confirm your booking by email.

By sending this booking form you are agreeing to our terms and conditions. To book, please save this form to your local drive and email it as an attachment to: . Alternatively, print and post it to the address at the end of this form.

Our postal address:

Public Protection Service, Building 4a Derriford Business Park, Plymouth. PL6 5QZ

OFFICE USE ONLY:

Date of paymentClick here to enter a date.Payment type Cheque ☐ Card ☐ Internal ☐Receipt No. Click here to enter text.

bookingform – Training centre courses.Page 1 of 3

For e-Learning candidates only. If more licences have been purchased for future requirements leave lines blank. If more space required please email
Workplace (site) if different / Learners
First name / Learners
Last name / Email address (used to send log in details) / Which e-Learning licence (course) is to be allocated?
Click here to enter text. / Click here to enter text. / Click here to enter text. / Click here to enter text. / Choose an item. /
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PART C (e-Learning only)