What is your proposed course?

What type of course is it? (e.g. home study, college, university, evening class)

Where is your chosen course (e.g. name of college, school etc.)

Are you currently working? YesNo

If “yes”, will you continue to work while you are studying? YesNo

If you are currently unemployed, what type of work would you like to do?

If you already have any qualifications, please list them below, with the approximate date when you obtained them:

Please say how your chosen course will improve your employment (if unemployed) or promotion (if currently employed) prospects? Or please say what you want the course to lead to (e.g. you may want to set up your own business, or be able to apply for jobs that need a specific qualification)

Is anyone able to support you on your course such as a college tutor or a support worker?YesNo

If “yes”, please give their contact details. We will not contact this person without your prior permission.

How can we help you with your course? Please tick all that apply and state approximate costs:

Please tell us if you require anything else to help you to do your course. Please state approximate costs, if any.