Short Course
Booking Form
Please complete using BLOCK CAPITALS and ensure that your writing is legible.
Course Details:
COURSE TITLE:
Course Date:
Course Cost:
Applicants for Gas or Forestry courses should also complete the relevant section on page 2.
Applicant Details:
Title:
Date of Birth:
Forename:
Job Title:
Surname:
Address
Postcode:
E-mail:
Tel:
Mobile:
Tel:
Postcode:
Employer Reward Card Organisation:
Mobile:
Company Name (if applicable)
Address
*Employer Reward Card Signatories Name:
*Employer Reward Card: Employers that hold this card have one or more signatories please
include one of these names in this box.
Please ensure both sections above are completed if your employer is paying for the course.
Payment method must be indicated on page 3.
Additional Support Requirements:
Inverness College UHI welcomes students with disabilities. We would encourage you to disclose any
disability, health or medical condition and we will try to meet your needs where we reasonably can.
Please give details of any support needs you have.
(If English is not your first language please provide details in this section).
Forestry Courses: ONLY TO BE COMPLETED BY CANDIDATES APPLYING FOR FORESTRY
Completion of the following section is MANDATORY when applying for courses delivered by
the Scottish School of Forestry:
Do you have a condition which may affect any of the following? If appropriate, please provide
additional information.
Mobility (e.g. arthritis, stroke)
Yes / No
Alertness (e.g. diabetes or alcohol/drug dependency)
Yes / No
Physical strength (e.g. heart condition)
Yes / No
Vision (which cannot be corrected by glasses or contact lenses)
Yes / No
Manual dexterity/grip strength (e.g. Vibration white finger (Raynaud’s Disease) or similar condition)
Yes / No
Balance (e.g. vertigo or giddiness)
Yes / No
Do you suffer from any condition or take medication which may impair your ability to operate
machinery? (f Yes, please provide details)
Yes / No
Additional information
Trainee Signature:-
Gas Courses: ONLY TO BE COMPLETED BY CANDIDATES APPLYING FOR GAS COURSES
CCN1 Initial Training & Assessment (includes CPA1 from 01
April 2012)
Appliances Initial Training & Assessment (CENWAT, CKR1,
HTR1)
DAH1 Training & Assessment
CCN1 Reassessment Training & Assessment (includes CPA1
from 01 April 2012)
Appliances Reassessment Training & Assessment (CENWAT,
CKR1, HTR1)
DAH1 Training & Assessment
CoNLPG1 Training & Assessment (LPG) - PD & RPH
Additional Option - LAV
Additional Option - B
OFTEC: OFT105E, 101 & 600 A (delete as appropriate)
Price (£)
()
Course Date
680
470
200
600
400
200
400
200
200
600
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Course Fee Payment:
To guarantee you a place on your selected course you are required to pay course fees in full
10 days prior to the start date of the course, or to provide a Purchase Order or an Employer
Letter of Intent.
Please select the appropriate payment option below.
Method of
Payment
()
Payment by
cheque
I enclose a cheque for £ ……….. as payment for ……… Delegates
Payment by credit
card
If you prefer to pay by credit/debit card, please complete and return the
enclosed form or contact the College on 01463 273000 (Amex not
accepted)
Payment by ILA
If the course costs more than the balance on your ILA account please
enclose a cheque for the difference or make payment by credit/debit
card.
(Cheques should be made payable to Inverness College UHI)
Please fill out and return the yellow ILA booking form.
Payment by
invoice
Purchase Order or Letter of Intent must be submitted with Booking
Form.
Payment and Cancellation Policy
1. All course fees must be paid for in full prior to the start of the course unless agreed in writing in
advance with Inverness College UHI, Finance Department or an appropriate Purchase Order or
Letter of Intent received.
2. I acknowledge that I am personally liable to Inverness College UHI for payment of all course
fees. In the event of any fee paying authority, other person or body not making payment on my
behalf, I undertake to make payment of the full amount due to Inverness College UHI.
3. Cancellations may be given over the phone but must be confirmed in writing.
4. For cancellations received less than 10 working days before the start of the course or once the
course has started, there is no fee refund. Substitutions can be made at any time before the start
of the course, however if the course is being delivered by the Scottish School of Forestry, the
substitute must complete and return the medical questionnaire prior to being accepted on the
course.
5. Should delegates have to be registered with an awarding body in advance of the course, then in
the event of a delegate cancelling, irrespective of the amount of notice given, the registration fees
are non-refundable.
6. Inverness College UHI reserves the right to cancel any course at any time, in which case
alternative dates will be offered or a full refund given
I accept the booking conditions as above
Signature
For Office
Use Only
Budget Code
Area Code
Date
Account No
Source of Information
What method of communication do you feel has encouraged you to apply to Inverness College UHI?
Please tell us where you heard about Inverness College UHI and the course(s) applied for:
Radio Advert
School Visit
Prospectus
Open Events
Newspaper/Magazine Advert
Community Events e.g. Black Isle Show
Train Station Advertising
Bus Advertising
Press Stories
Facebook/Twitter
Our Website
Another Website (please state which)
…………………………………………..
None of the Above
Data Protection
Inverness College UHI is committed to ensuring that the processing of personal data is only
undertaken in the legitimate operation of the College’s business. The College collects and uses
information (data) about its students and stores it in accordance with the Data Protection Act 1998.
By providing us with your personal data and by signing this form on page 3, you provide your
explicit consent to us processing the said data for the purposes of your educational/training
programme.
We will only provide such information to third parties where we are obliged to do so by law: for
statistical reporting (e.g. Scottish Funding Council); to awarding bodies for certification purposes;
and to employers and sponsoring bodies who pay student fees.
Data Sharing Agreement
Inverness College UHI has a data sharing agreement in place with Skills Development Scotland
(SDS), which involves reporting on the destination of school leavers (aged 16-19 years) for
research purposes. Should you leave your course prior to completion, this data sharing will allow
SDS to offer you careers advice and support. By signing this form on page 3, you provide your
explicit consent to us sharing your personal data with SDS for this purpose. SDS has advised they
may retain your data up to the date of your 27th birthday.
Please tick the box if you DO NOT want us to share your personal data and sensitive personal data with SDS
Inverness College UHI, 1 Inverness Campus, Inverness, IV2 5NA
Pauline Tuthill Tel: (01463) 273307
Email: [email protected]
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