Learning and Skills Prospectus Spring 2020

APPLICATION FORM 2020
IMPORTANT - HAVE YOU BEEN A LEARNER WITH US BEFORE? Y N
Personal details - please provide your contact details
Title Mr Mrs Ms Miss Other Gender: Male Female
First name(s):
Address:
Postcode:
Telephone No:
National Insurance Number:
Surname:
Email:
Mobile No:
Date of birth:
Have you lived in the UK (or EEA) for the last 3 years?: Yes No If no, please ring one of our advisers on 0345 600 6400
In the event of accident or emergency, please tell us who you would like us to contact and their contact details
Course(s) applied for Please tell us which course(s) you want to apply for and where you want to study with us. If you aren’t sure what you are
looking for then please ring one of our advisers on 0345 600 6400
Course code: Course title: Location: Start date: Fee:
Paying for your course(s) Please indicate below how you would like to pay
I enclose a cheque payable to Northumberland County Council
I will apply for an Advanced learning Loan I would like to claim fee remission on grounds below
Total Amount:
Choosing your course: On courses where we offer fee remission and you wish to claim your discount, please choose below which category of fee
remission you are entitled to: you won’t be asked to make a payment to us. Instead you must bring with you evidence of your entitlement before
you start the course. If you cannot provide the evidence, you will need to either pay for the course in full or an offer of a place may be withdrawn.
I wish to claim free tuition because I am:
16-18 at the start of the course and not enrolled at another institution
for more than 2 weeks.
19-23 and undertaking a Traineeship
19-23 studying English or maths learning aims up to level 2, including
studying GCSE English or maths, where you do not currently have these
qualifications at grades A* to C or grades 4 – 9.
19-23 studying up to and including level 1 and have not yet achieved
above level 1, and progressing to first full level 2
19-23 studying first full level 2 qualification (and the qualification
must be part of the legal entitlement)
19-23 studying first full level 3 qualification (and the qualification
must be part of the legal entitlement)
Unemployed and studying up to and including Level 2 and one of the
following applies:
You receive Jobseeker’s Allowance (JSA), including those receiving
National Insurance credits only.
You receive Employment and Support Allowance (ESA).
You receive Universal Credit, and your earned income from employment
(disregarding benefits) is less than £338 a month (you are the sole adult
in your benefit claim) or £541 a month (you have a joint benefit claim
with your partner).
24 years +
Studying English or maths learning aims up to level 2, including studying
GCSE English or maths, where you do not currently have these
qualifications at grades A* to C or grades 4 – 9.
Unemployed and studying up to and including Level 2 and one of the
following applies:
You receive Jobseeker’s Allowance (JSA), including those receiving
National Insurance credits only.
You receive Employment and Support Allowance (ESA).
You receive Universal Credit, and your earned income from employment
(disregarding benefits) is less than £338 a month (you are the sole
adult in your benefit claim) or £541 a month (you have a joint benefit
claim with your partner).
We can also use our discretion to fund other learners if the
following apply:
You receive other state benefits (not listed opposite) and your earned
income (disregarding benefits) is less than £338 a month (you are the
sole adult in your benefit claim) or £541 a month (you have a joint benefit
claim with your partner) and the course is directly relevant to your
employment prospects and the local labour market needs.
You want to be employed or progress into more sustainable employment,
and your earned income (disregarding benefits) is less than £338 a
month (you are the sole adult in your benefit claim) or £541 a month
(you have a joint benefit claim with your partner) and the course is
directly relevant to your employment prospects and the local labour
market needs.
Low wage flexibility
You may qualify for full fee remission (No fee) if you meet the eligibility
criteria for funding and you are employed but earning an annual gross
salary of less than £16,009.50. You will need to provide a recent wage
slip, Universal Credit statement, or current employment contract that
states your gross monthly / annual wages.
Please note: you will be asked to provide suitable evidence of
HOW WE USE YOUR PERSONAL INFORMATION
This privacy notice is issued by the Education and Skills Funding Agency (ESFA), on behalf of the Secretary of State for the Department of Education (DfE). It is to inform learners how their
personal information will be used by the DfE, the ESFA (an executive agency of the DfE) and any successor bodies to these organisations. For the purposes of relevant data protection legislation,
the DfE is the data controller for personal data processed by the ESFA. Your personal information is used by the DfE to exercise its functions and to meet its statutory responsibilities, including
under the Apprenticeships, Skills, Children and Learning Act 2009 and to create and maintain a unique learner number (ULN) and a personal learning record (PLR). Your information will be
securely destroyed after it is no longer required for these purposes. Your information may be shared with third parties for education, training, employment and well-being related purposes,
including for research. This will only take place where the law allows it and the sharing is in compliance with data protection legislation. The English European Social Fund (ESF) Managing
Authority (or agents acting on its behalf) may contact you in order for them to carry out research and evaluation to inform the effectiveness of training.
FOR OFFICE USE ONLY
Payment Method: Receipt No: Total recevied:
Send to: Learning & Skills Service - Gemma Lee, Blyth Adult Learning, Brunel Building, Regent Street, Blyth, NE24 1LT, Tel: 01670 622 099.