Participant Form
This form should be completed by individuals registering on a support & training course offered
through the BEST Programme. You should give the original signed copy of this form to your
training provider prior to the start of the course.
The information you provide will be stored securely and confidentially in line with the Data
Protection Act. Your training course provider, the BEST Programme Office and the Welsh
European Funding Office are the only people who will have access to this information.
The information collected in this form may be used anonymously to monitor course uptake and
completion by different participant groups. Your information will not be shared with any third
party.
Completing this form
Participants enrolling on a BEST training course are required to complete Section 1 –
Participant Details and Section 2 – Equal Opportunities Information and return the form
to the BEST Programme.
You may be asked to evidence eligibility by providing supplementary information,
including wages details prior to commencing the course.
Please return a completed and signed version of this form to:
BEST
Welsh School of Architecture
55 Park Place
Cardiff University
Cardiff CF10 3AT
Email: [email protected]
BEST is supported by the European Social Fund, through the Welsh Government to deliver
training until July 2015.
Section 1 – Participant Details
About You
Title
First Name
Surname
Home Address
Postcode
Email
Telephone
Date of Birth
NI Number
Unique Learner
Number (if known)
Gender
Male ☐
Female ☐
Preferred language for communication
Welsh ☐
English ☐
About where you live
Unitary Authority where you live (please select one only)
☐ Blaenau Gwent
☐ Flintshire
☐ Powys
☐ Bridgend
☐ Gwynedd
☐ Rhondda Cynon Taff
☐ Caerphilly
☐ Isle of Anglesey
☐ Swansea
☐ Cardiff
☐ Merthyr Tydfil
☐ Torfaen
☐ Carmarthen
☐ Monmouthshire
☐ Vale of Glamorgan
☐ Ceredigion
☐ Neath Port Talbot
☐ Wrexham
☐ Conwy
☐ Newport
☐ Outside of Wales
☐ Denbighshire
☐ Pembrokeshire
About your previous study
Highest level of qualification (please select one only)
☐ None
☐ Level 2
☐ Levels 4 – 6
☐ Below Level 2
☐ Level 3
☐ Levels 7 – 8
Employment Details
Employment Status
☐ Employed (excluding self-employed)
☐ Self-employed
☐ Unemployed (up to one year)
☐ Long-term unemployed (over one year)
☐ Economically inactive (excluding full-time education)
☐ In full time education
If employed or self-employed, please complete the following)
Company Name
Company Address
Postcode
Telephone
Declaration
I declare that the information I have provided is correct and relates to my participation
within the BEST Programme.
Signed
Print Name
Date
I consent for my information to be passed to WEFO and to be securely held for the lifetime
of the Programme and used only for research purposes. After the Programme end, details
will be destroyed.
☐ Yes
☐ No
If consent is not given the details provided will be used anonymously.
How did you find out about this course?
Would you be interested in finding out more about the BEST
Programme and courses available?
☐ Yes
☐ No
Section 2 - Equal Opportunities Information
As part of our monitoring we are required to collect statistics on our participants. The
information collected in this form will be used anonymously to monitor course uptake and
completion by different participant groups.
The information you provide will be stored securely and confidentially in line with the Data
Protection Act. Your training course provider, the BEST Programme Office and the Welsh
European Funding Office are the only people who will have access to this information. Your
information will not be shared with any third party.
Gender
☐ Male
☐ Female
☐ Prefer not to say
Age when starting
current training
programme
☐ 11 – 14
☐ 25 – 54
☐ 65+
☐ 15 – 24
☒ 55 - 64
☐ Prefer not to say
Disabled
☐ Yes
☐ No
☐ Prefer not to say
☐ Asian
☐ Asian British
☐ Asian English
☐ Asian Irish
☐ Asian Scottish
☐ Asian Welsh
☐ Indian
☐ Pakistani
☐ Bangladeshi
☐ Chinese
☐ Other
Dual Heritage:
Ethnicity
☐ Black
☐ Black British
☐ Black English
☐ Black Irish
☐ Black Scottish
☐ Black Welsh
☐ Caribbean
☐ African
☐ Other
☐ White
☐ White British
☐ White English
☐ White Irish
☐ White Scottish
☐ White Welsh
☐ Other
Migrant
☐ Yes – EU
☐ Gypsy / Traveller
/ Romany
☐ White & Black
Caribbean
☐ White & Black
African
☐ White & Asian
☐ Other_________
☐ Other description
______________
☐ Prefer not to say
☐ No
☐ Prefer not to say
☐ Yes –Non-EU
Work limiting
health condition
☐ Yes
☐ No
☐ Prefer not to say
Receiving
assistance with
work limiting
☐ Yes – Individualised
assistance
☐ Yes – General
assistance
☐ No
☐ Prefer not to say
health condition or
disabilities
Receiving support
with caring
responsibilities
☐ Yes
☐ No
☐ Prefer not to say
Lone Parent
☐ Yes
☐ No
☐ Prefer not to say
Welsh Language Skills
Understand Welsh
☐ Yes
☐ No
☐ Prefer not to say
Speak Welsh
☐ Yes
☐ No
☐ Prefer not to say
Read Welsh
☐ Yes
☐ No
☐ Prefer not to say
Write Welsh
☐ Yes
☐ No
☐ Prefer not to say