Learning difficulties, disabilities and health problems
Do you have a learning difficulty?
Do you have any of the following learning difficulties? (please check all that apply)
Do you have a disability or health problem?
Do you have any of the following disabilities and health issues? (please check all that apply)
Do you need assistance to exit the building in the event of an emergency evacuation? Staff will prepare a Personal Emergency Evacuation Plan (PEEP) with you.
It may be helpful for your tutor to have this information. Are you happy for this information to be passed onto them?
You may wish to discuss your needs with your tutor so we can make reasonable adjustments to support your learning.
To ensure that you meet the eligibility criteria of the ESFA, please provide evidence of eligibility by uploading a copy of your documents. This may be a valid passport or photo driving licence.
I am providing a copy of my:
If you have not applied for a passport or driving licence please select and provide a copy of one of the following:
Prior Attainment Declaration
What is the highest level you have achieved in your previous learning?
Were you in Full-time Education or Training before you enrolled at the provider for the first time?
Employment Status Declaration
What is your employment status?
If you are employed, or self-employed, how many hours per week do you work?
If you are employed, what is your income level?
If you are on a low income you may have an entitlement to fully-funded learning (free to the learner) for some courses.
If you are not in paid employment, or are retired, for how long have you not been in paid employment?
Are you on benefits?
Please tick the appropriate box
If you are on benefits you may be eligible for a concessionary fee, or you may have an entitlement to fully-funded learning (free to the learner) for some courses
Contact Preferences, Photographic consent and Privacy Notices
Privacy Notice for Greater London Authority Adult Education Budget: How We Use Your Personal Information
The Greater London Authority (GLA) is London’s regional government. The Mayor of London provides Citywide leadership, and the London Assembly
is a watchdog for London responsible for holding the Mayor and his advisers to public account. Find out more about what we do and who we work with
The Mayor of London is responsible for the Adult Education Budget (AEB) in London, and the funding for your course. This funding is being used to
‘match fund’ a European Social Fund (ESF) programme for residents in Greater London.
The majority of the information provider by you in this Enrolment form is collected by the GLA, which operates as a data controller of your personal data
under relevant data protection law. The GLA is required to process your personal data to enable it to carry out its functions and statutory
responsibilities including reporting to the Department of Work and Pensions (DWP) on the ‘match funding’ of ESF programmes. In addition, the GLA
collects some supplementary information to comply with ESF requirements, for which the DWP is the data controller.
Information about use of and access to your personal data held by the GLA, details of the organisations with whom the GLA regularly share data
information about how long the GLA retain your data, and how to exercise your rights is set out in the GLA AEB Procured Privacy Notice
It is important to us to be able to find out how well our delivery is meeting your needs. We would like to know how your learning has impacted on you, including if it has led you into work, further learning, volunteering, etc. In order to do this, we would like to be able to contact you in future. We value your feedback.
I am happy to be contacted about further courses or learning opportunities
I am happy to be contacted for surveys and research
I prefer to be contacted by
There are occasions when photographs of activities are taken for publicity and marketing purposes. Do you agree for your image to be used?
Royal Borough of Kensington and Chelsea Privacy notice – additionally to the GLA privacy notices the Royal Borough of Kensington and Chelsea
will use Learner’s personal data collected by the delivery partners or by the Royal Borough of Kensington and Chelsea’s Adult Learning Service to
comply with its contractual obligations to the GLA. The information being collected is the personal details of learners who are taking part in courses
funded by the GLA – it is a requirement that all individuals taking part in a course subsidised by the GLA provide these details. These details include
evidence that the learner meets the eligibility requirements specified by the Funding Rules.
Your information may be shared with third parties for education, training, employment- and well-being related purposes, including for research and
surveys about the Adult Learning Service. This will only take place where the law allows it and the sharing is in compliance with the Data Protection Act
2018. Your information will be kept in hard copy and on the Learnertrack database system. Paper copies will be kept until 31 July 2030 according to
the ESF regulations for all learning undertaken between 2014 and 2020. After which paper copies will be shredded or burnt. Online data will be subject
to suitable destruction software tools to erase data from hard drives.
Westway Trust is a delivery partner of Royal Borough of Kensington and Chelsea. While we are socially distancing, your information will also be collated through the Westway Trust website and will also comply with the above conditions.
Learner Declaration and Learning Agreement
· I confirm that the information I have provided on this form is correct and complete.
· I confirm that I have been provided with a copy of the privacy notices in relation to my enrolment and I agree to share this information with the relevant bodies.
· I have received advice and guidance about the suitability of my learning programme, the entry requirements and the support available. I understand the implications of my choice of learning programme and I am satisfied that this learning programme is suitable for my needs.
· I will notify the learning provider of any changes of my circumstances which may affect my programme.
· I will attend classes and be on time. If I cannot come, I will telephone the learning provider or my tutor. I agree to complete assignments within agreed time limits and take any examinations that are part of my learning programme.
· I understand that my programme is part financed by European Social Fund, as part of the Education and Skills Funding Agency co-financing arrangement.)