School for work place and technical skills

Welcome to our simple on line application form. Please complete all boxes marked *""**
Course Title *:
Desired Course Date (or leave blank):
Course location:
Surname *:
First Name *:
House name/number *:
Address line 1 *:
Address line 2 *:
City/Town:
County:
Post Code *:
Contact Telephone:
Contact email:
Please describe your previous experience (relevant to the course): *:
What do you hope to gain from this course * (Motivation)::
Please list your professional memberships and qualifications::	None (default answer)

How did you hear about this course? *:
Data Protection. We will store your infromation on our database ONLY to provide you with information on our courses. We never sell or pass on your personal information. Please confirm you have read our terms and conditions by typing YES or NO into the box below.
Please type Yes to accept or No to not accept our terms *:
Do you require any specific needs, e.g. access or medical::
If "yes," we will contact you and ask for details.
You will now be asked to confirm the payment method and amount. Please note, our terms require full payment OR a standing order before the course start date and a deposit may be required. No need to send payment at this stage.
Please choose your payment method:
Please state the full course fee *:
Thank you for completing this application, we will reply shortly. Once we write confirming a place, you will need to pay your deposit within 14 days to secure your place. If you have any questions or need assistance, then please contact me. Kind regards Sam Leavy

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