Care Training Application FormLearner Enrollment FormLearner Enrollment FormWelcome to Care Trainings! Please fill out this form completely before enrolment. Ifyou have any questions or need assistance, feel free to contact usPersonal Information1. Full Name:First NameMiddle NameLast Name2. Date of Birth:3. Gender: Male Female Other Prefer not to say4. Contact Information:Address:Postal Code:Country:- Select -AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCity:Phone Number:Email Address:5. Emergency Contact InformationName:Relationship:Phone Number:Email Address:6. Educational BackgroundHighest Level of Education Completed:- Select -High SchoolAssociate DegreeBachelor’s DegreeMaster’s DegreeDoctorateOtherIf selected Other please specify:7. Previous Qualifications (if any):8. Employment InformationCurrent Employer:Position:Work Address:Work Phone Number:9. Course InformationQualification Applied For:- Select -Intensive English - Online (SL) - £350Intensive English - Abroad (UK) - £1,450Semi Intensive English - Online (SL) - £350Semi Intensive English - Abroad (UK) - £1,450Level 2 - Diploma In Care - Online (SL) - £1,500Level 2 - Diploma In Care - Abroad (UK) - £3,000Level 3 - Diploma In Care - Online (SL) - £2,500Level 3 - Diploma In Care - Abroad (UK) - £4,000Level 5 - Diploma In Leadership & Management In Health & Social Care - Online (SL) - £4,500Level 5 - Diploma In Leadership & Management In Health & Social Care - Abroad (UK) - £5,500Level 3 - Preparing To Work In Adult Social Care In UK - Online (SL) - £500Level 3 - Preparing To Work In Adult Social Care In UK - Abroad (UK) - £1,500Level 2 - Diploma In Management Principles - Online (SL) - £1,450Level 2 - Diploma In Management Principles - Abroad (UK) - £3,450Level 3 - Diploma In Business & Administration - Online (SL) - £1,700Level 3 - Diploma In Business & Administration - Abroad (UK) - £4,950Level 5 - Diploma In Leadership & Management - Online (SL) - £2,950Level 5 - Diploma In Leadership & Management - Abroad (UK) - £6,450Level 7 - Diploma In Strategic Management & Leadership - Online (SL) - £4,450Level 7 - Diploma In Strategic Management & Leadership - Abroad (UK) - £9,450Reason for Enrolling:10. Additional InformationNotes or any payment queries / otherIf yes, please specify:How did you hear about us? Friend/Family Website Social Media OtherIf selected other, please specifyDeclarationI declare that the information provided in this form is accurate and complete to the bestof my knowledge. I understand that any false information may result in the cancellationof my enrollment.First NameLast NameDate:11. Do you have any special requirements or need any accommodations? Yes NoSubmit