Course Choice * Please choose... Allergy Awareness for the Service Sector Allergy Awareness for Working with Children Allergy Awareness in Adult Social Care Awareness of Bullying in Children & Young People Behaviour That Challenges Behaviour That Challenges in Children Business Administration Care & Management of Diabetes Care Planning Caring for Children & Young People Caring for the Elderly Children & Young People's Mental Health Common Childhood Illnesses Common Health Conditions Counselling Skills Dignity & Safeguarding in Adult Social Care End of Life Care Equality & Diversity Event Planning Falls Prevention Awareness Improving Personal Exercise, Health and Nutrition Information, Advice or Guidance Lean Organisation Management Living in a Fair and Diverse Society Mental Health Problems Nutrition & Health Preparing To Work in Adult Social Care Prevention & Control of Infection Principles of Customer Service Principles of Dementia Care Principles of the Mental Health Care Worker Safe Handling of Medication Safeguarding, Prevent & British Values Self Harm, Suicide Awareness & Prevention Specific Learning Difficulties Team Leading Understanding Autism Understanding Environmental Sustainability Working with Individuals with Learning Disabilities Principles of Dementia Care ( Level 3) End of Life Care (Level 3) Understanding Autism (Level 3) Understanding Mental Health (Level 3)
Learning Method * Please choose... Online learning materials with online assessment Paper based assessments with a book
Do you consider yourself to have a learning difficulty and/or disability and/or health problem? * Please choose... No Yes
Primary: * Please choose... Visual Impairment Hearing Impairment Disability Affecting Mobility Profound Complex Disabilities Social Emotional Difficulties Mental Health Difficulty Moderate Learning Difficulty Severe Learning Difficulty Dyslexia Dyscalculia Autism Spectrum Disorder Asperger’s Syndrome Temporary Disability Speech, Language & Communication Needs Other Physical Disability Other Specific Learning Difficulty (e.g. Dyspraxia) Other Medical Condition (e.g. epilepsy, asthma, diabetes) Other Learning Difficulty Other Disability Prefer Not to Say
Option 2: Visual Impairment Hearing Impairment Disability Affecting Mobility Profound Complex Disabilities Social Emotional Difficulties Mental Health Difficulty Moderate Learning Difficulty Severe Learning Difficulty Dyslexia Dyscalculia Autism Spectrum Disorder Asperger’s Syndrome Temporary Disability Speech, Language & Communication Needs Other Physical Disability Other Specific Learning Difficulty (e.g. Dyspraxia) Other Medical Condition (e.g. epilepsy, asthma, diabetes) Other Learning Difficulty Other Disability Prefer Not to Say
Option 3: Visual Impairment Hearing Impairment Disability Affecting Mobility Profound Complex Disabilities Social Emotional Difficulties Mental Health Difficulty Moderate Learning Difficulty Severe Learning Difficulty Dyslexia Dyscalculia Autism Spectrum Disorder Asperger’s Syndrome Temporary Disability Speech, Language & Communication Needs Other Physical Disability Other Specific Learning Difficulty (e.g. Dyspraxia) Other Medical Condition (e.g. epilepsy, asthma, diabetes) Other Learning Difficulty Other Disability Prefer Not to Say
Option 4: Visual Impairment Hearing Impairment Disability Affecting Mobility Profound Complex Disabilities Social Emotional Difficulties Mental Health Difficulty Moderate Learning Difficulty Severe Learning Difficulty Dyslexia Dyscalculia Autism Spectrum Disorder Asperger’s Syndrome Temporary Disability Speech, Language & Communication Needs Other Physical Disability Other Specific Learning Difficulty (e.g. Dyspraxia) Other Medical Condition (e.g. epilepsy, asthma, diabetes) Other Learning Difficulty Other Disability Prefer Not to Say
Option 5: Visual Impairment Hearing Impairment Disability Affecting Mobility Profound Complex Disabilities Social Emotional Difficulties Mental Health Difficulty Moderate Learning Difficulty Severe Learning Difficulty Dyslexia Dyscalculia Autism Spectrum Disorder Asperger’s Syndrome Temporary Disability Speech, Language & Communication Needs Other Physical Disability Other Specific Learning Difficulty (e.g. Dyspraxia) Other Medical Condition (e.g. epilepsy, asthma, diabetes) Other Learning Difficulty Other Disability Prefer Not to Say
Please select your ethnic origin: * Please choose... African Arab Bangladeshi British Caribbean Gypsy or Irish Traveller Indian Irish Other Asian background Other Black background Other Chinese Other Mixed background Other White background Pakistani White & Asian White & Black African White & Black Caribbean Other Not known / Prefer not to say
Please specify your ethnic origin: *
Do you have any convictions, cautions, reprimands or final warnings that are not ‘protected’ as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013) by SI 2013 1198? * Please choose... Yes No
Are you currently or have you ever been the subject of any investigation or inquiry by the police, a statutory agency or any other body, into abuse or neglect of a child or vulnerable adult or other inappropriate behaviour? * Please choose... Yes No
Employment Status: * Please choose... Employed Not Employed
Employment Type: * Please choose... In paid employment – 0–10 hours per week In paid employment – 11–20 hours per week In paid employment – 21–30 hours per week In paid employment – 31 hours or more per week Self employed
Hours worked per week: * Please choose... 0–10 hours 11–20 hours 21–30 hours 31 hours or more
Unemployed Type: * Please choose... Not in paid employment and looking for work Not in paid employment and not looking for work In full-time education prior to the start of the course Retired
How long have you been unemployed? * Please choose... Less than 6 months 6 - 11 months 12 - 23 months 24 - 35 months 36 months or more
Form of ID given: Please choose... Driving Licence Passport Birth Certificate National Identity Card
Preferred Contact Method: Please choose... Text Phone Email
