LSCB Inter-Agency Training Course Application Form
Applicant Details
Forename
Surname
Job title
Team/Dept
Full Workplace
Address
Tel
Mobile
Email
Please indicate your agency
TH PCT / BLT
ELFT
NHS
Private Sector
Voluntary Sector
Independent Service
Further Education Institution
Other (Please Specify)
Course Details
Course Title
Date(s)
Course Fees
Please indicate which category your organisation falls within
Staff from a LSCB contributing member Includes NHS staff (whose Trust makes a contribution to the
LCSB and the training programmes) and LBTH staff (no charge)
Members of staff from Local Charities or Small Voluntary Community Groups, faith, community
and residents organisations of under 20 people. (no charge)
Schools Staff with SLAs (£100 per day. £50 per half day)
Staff from organisations commissioned by LBTH unless a different provision is specified in
contracts. (£100 per day. £50 per half day)
Staff from organisations of over 20 people such as large national charities working in Tower
Hamlets or private organisations contracted by Tower Hamlets to provide services e.g. NSPCC,
NCH, Private Fostering Agencies, Residential Homes/Schools where Tower Hamlets children are
placed. (£100 per day. £50 per half day)
Staff from other private organisations (£110 per day. £55 per half day)
Full Invoicing Details
Bugdet Holder
Invoicing Address
Previous safeguarding children training undertaken
Dates attended single agency safeguarding children
training in the last 2 years
Length of single agency safeguarding training attended
e.g. ½ day / 1 day
All applications must be approved by your line manager
I have discussed the aims of the course with my staff member and I recommend s/he be allocated a
place. I will release him/her to attend the course when it is confirmed. I realise that my department will
incur a nominated charge of £100.00 per course day if the staff member is unable to attend and does
not notify Workforce Learning and Development by confirmed email at least 48 hours in advance of the
course date.
Manager’s name
Manager’s signature
Date
Applicant’s signature
Date
Equal Opportunities Information
Do you consider yourself to have a disability?
Yes
No
Do you require any additional support/access requirements?
Are you Male or Female?
Male
Female
Ethnic Background
Asian
Bangladeshi
Indian
Pakistani
Chinese
Vietnamese
Other:
White
English
Irish
Scottish
Welsh
Other:
Black
African
Caribbean
Somali
Other:
Mixed / Dual Heritage
White & Black African
White & Black Caribbean
White & Asian
Other:
Any other background – please state:
Decline to state
Please return your completed application to:
Email:
[email protected]
Fax:
0207 364 4047
Tel:
0207 364 1126
Post:
Central Services, Workforce Development, 6th Floor Anchorage House, 2 Clove Crescent,
London E14 2BE