Name
*
First Name
Last Name
Date Of Birth
MM
DD
YYYY
Email
*
Phone
(###)
###
####
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
NI Number
Ethnicity
English/Welsh/Scottish/Northern Irish/ British
Irish
Gypsy or Irish Traveler
White and Black Caribbean
White and Black African
White and Asian
Gender
Male
Female
Other
Prefer not to say
Disability
Learner Considers themselves to have learning difficulities/and or a disability/and or a health problem
Learner Does NOT Consider themselves to have learning difficulties/and or a disability/and or a health problem
Learning Difficulties and (LLDDs)
None
Vision impairment
Hearing impairement
Disability affecting mobility
Profound complex disablilities
Social & Emotional difficulties
Mental health difficulty
Moderate learning difficulty
severe learning difficulty
Dyslexia
Autism spectrum disorder
Aspergers syndrome
Temporary Disability after illness or accident
Speech , language or communication needs
Other physical disability
Other learning difficulty
Other medical condition(for example: Asthma, Epilepsy or diabetes)
Prefer not to say
Do you have an Education Health Care Plan (EHCP)/Statement SEN or Learning Difficulty Assessment (LDA) *
Yes
No
N/A
Next of Kin Name
First Name
Last Name
Next of Kin Relationship
Next of Kin Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Next of Kin Email
Next of Kin Emergency Contact Telephone number
(###)
###
####
Available to start
MM
DD
YYYY
GCSE English Grade
1
2
3
4
5
6
7
GCSE Maths Grade
1
2
3
4
5
6
7
Date you Left school or college
MM
DD
YYYY
. What is the name of the school or college you attend now or the last one you attended?
Are you /have you been on any other Government funded training programmes?
Yes
No
Are you currently in education, employment or training?
Yes
No
If you have answered Yes to any education question and wish to give further details please enter them below:
If you have an Equine qualifications please give details (Title, level grade etc.) below:
What is your Nationality?
How long have you lived in your country of residence (years/months)?
If your first language is not English, do you require additional support?
Yes
No
Tell us about your hobbies, interests, leisure activities, things you are good at and any achievements, awards and responsibilities you may have had:
My Career aims are:
. Please give details of any work experience, voluntary work and/or employment you have had:
Have you worked with horses before?
Yes
No
Have you any riding experience?
Yes
No
If Yes then give us brief details:
Please provide us with the names and addresses of two referees (not relatives) and how they know you.
If you left school in the last 2 years, one referee should be your Head Teacher or Form Tutor.
Do you have any existing injuries or medical conditions that may impact on your ability to take the course?
Yes
No
please give a brief description of your injury or condition. We may ask for more details at interview.
What is your height (ft./in or m/cm)
What is your weight (st/lb or kg)?
Which TOEC Course are you applying for?
Level 1 Equine care
Level 2 diploma in equine management
Level 3 Advanced diploma in Equine management
Level 2 Apprenticeship – Equine Groom
Level 3 Apprenticeship- Senior equine groom
Please indicate your current status in the UK (please mark the appropriate box)?
How We Use Your Personal Information The personal information you provide is passed to the Chief Executive of Skills Funding (“the Agency”) and, when needed, the Department for Education, including the Education Funding Agency to meet legal responsibilities under the Apprenticeships, Skills, Children and Learning Act 2009, and for the Agency’s Learning Records Service (LRS) to create and maintain a unique learner number (ULN). The information you provide may be shared with other partner organisations for purposes relating to education or training. Further information about use of, and access to, your personal data, and details of partner organisations are available at: http://skillsfundingagency.bis.gov.uk/privacy.htm, http://www.learningrecordsservice.org.uk/documentlibrary/documents/Code+of+Practice+for+Sharing+of+Personal+Information.htm
Other status description
Do you have any unspent convictions?
Yes
No
Please give brief details of any unspent convictions:
Are you in any of the following categories?
The Orchard Equine College collects information for its own and ESFA use and the privacy statement here covers how TOEC and ESFA use your personal information. You must select at least one option from the choices for allowed Contact and Preferred Contact Methods. The full TOEC GDPR Policy can be viewed here.
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 used for education, training, employment and well-being related purposes, including for research. The DfE and the English European Social Fund (ESF) Managing Authority (or agents acting on their behalf) may contact you in order for them to carry out research and evaluation to inform the effectiveness of training. Your information may also be shared with other third parties for the above purposes, but only where the law allows it and the sharing is in compliance with data protection legislation. You can agree to be contacted by other third parties by ticking any of the section below.
Further information about use of and access to your personal data, details of organisations with whom we regularly share data, information about how long we retain your data, and how to change your consent to being contacted, please visit: https://www.gov.uk/government/publications/esfa-privacy-notice
