Mohair Centre Training

REGISTRATION FORM




NAME:        


ADDRESS:



POST CODE:


E-MAIL ADDRESS:


PHONE NUMBER - HOME:

                      - MOBILE:


DATE OF BIRTH:


PLEASE CIRCLE / TICK THE QUALIFICATION YOU WISH TO APPLY FOR:


Transitional Modules in Playwork (Early Years Playwork) 4964-30 TRANS 3


Diploma in Playwork (QCF) LEVEL 2 4964-02   PLAY 2


Diploma in Playwork (QCF) LEVEL 3 4964-03   PLAY 3


Certificate Children & Young Peoples Workforce Level 2 CERTIFICATE (QCF) 4227-01


EARLY YEARS EDUCATOR (EYE) Level 3 3605-03


4227-11 Diploma in Leadership for Children & Young Peoples Workforce Early Years (Management) Level 5


4227-12 Diploma in Leadership for Children & Young Peoples Workforce Early Years(Advanced Practice) Level 5


4964-05 Level 5 Diploma in Playwork


NOCN Level 3 Certificate in Forest School Programme Leadership


NOCN Level 2 Award in Forest School Programme Support


NOCN Level 1 Award in Introduction to Forest School Principles

WORKPLACE  ADDRESS AND PHONE NUMBER:




LINE MANAGER:



SOURCE OF FUNDING :  (PLEASE TICK)

SELF FUNDED:   (FULL / INSTALLMENTS)

Installments are normally arranged as an initial payment to cover start-up costs followed by monthly payments paid by standing order. Please give billing address for invoice.


CEYCP Bursary (Brighton & Hove)

Who will pay the Candidate Contribution? ……………………………………………

Please give billing address for invoice.


The bursary will be paid by Brighton & Hove Council (CEYCP)


WORKPLACE FUNDED

Please give billing address for invoice

  

TRAINING MONITORING:


Gender (Please circle/tick  where appropriate)


Male  / Female


Please specify below whether you have any additional needs:



Age:  16-24   25-49   50+


Ethnicity: (Please specify)


Any other relevant details?






Candidate Signature:      Date:






Please print and return this form to:  MOHAIR CENTRE TRAINING

2 Park Farm Cottages,

Laughton,

Lewes, East Sussex,

BN8 6BU.

Telephone Number: 01825 840759

Email: mohaircentretraining@hotmail.co.uk


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