Arduino for Beginners Sign Up - Fluxus Cornwall CIC

First Name(s)

Surname

Preferred Pronouns

Preferred name (if different to legal first name)

Address

Postcode

Phone

Email

Legal gender

Date of birth

Age

Employment status

Highest education attainment

Subject area

Ethnicity

White

English/ Welsh/ British/ Northern Irish Irish Gypsy/Irish Traveller White - Other

Mixed Multiple

White & Black Caribbean White & Black African White & Asian Mixed Multiple - Other

Black / African / Black British / Caribbean

African Caribbean Other

Other Ethnic Group

Arab Other

Other

Choose not to say

Learning Difficulty Status

No Yes Prefer not to say

Disability / Ill Health (Inc Mental Health)

No Yes Prefer not to say

Do you feel that any of the 9 protected characteristics will affect employment/training? These are: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, sexual orientation

No Yes Prefer not to say

Are you able to provide at least one of the following to prove your identity?

Payslip (displaying UK NI No) issued in the last 3 months Full Passport (UK) Birth/Adoption Certificate (EU Member State) with National Insurance Card / official document showing National Insurance number and name issued by a government agency or a previous employer Marriage/Civil Partnership Certificate (required if Birth Certificate/Passport in previous name) Full Passport (non-UK) and National Insurance Number Immigration Status Document

PRESENT SITUATION (current skills/qualifications)

• Current skills and qualifications.
• Qualifications in the skills area.
• Current employment & role.
• Highest level of qualification.
• Why this course?
• How will it help?

SHORT-TERM / LONG-TERM PLANS: (what effect will the course have, how will you use what you learned)

• What are your short-term goals?
• What are your long-term goals?
• What would you like to go on to do in the future?
• What will this course enable you to achieve (in work/life)

ACTION PLAN / TRAINING NEEDS (inc. relevance to current role, retraining or new training):

• Is the course relevant to your current role, are you hoping it will help you progress within your current company, or is it to help you move on to somewhere else?
• Are you happy with self-study outside of the scheduled sessions and are they able to fit in the time for assignments?

SUPPORT REQUIRED: (inc. permission to contact employer)

If the course benefits your employer, can we contact them?
• Will you need any support in order to attend the course?
• Do you have any barriers to learning or need any additional support?

The information you provide to Truro and Penwith College as part of the Shared Prosperity Fund (SPF) Digital Futures Cornwall may be shared with the Ministry of Housing, Communities and Local Government (MHCLG), Cornwall Council and Lead Applicant (Truro & Penwith College) and used for monitoring and evaluating purposes, in line with UK Shared Prosperity Fund regulatory requirements. The MHCLG is a data controller for all UK Shared Prosperity Fund related personal data collected with the relevant forms submitted to MHCLG, and the control and processing of Personal Data.

As part of the process of assessment and monitoring of the UK Shared Prosperity Fund, MHCLG will share your personal data with relevant government departments or arm’s- length bodies. For more information about how your personal data is used and your individual rights please visit the UK Shared Prosperity Fund Privacy Notice UK Shared Prosperity Fund: privacy notice - GOV.UK (www.gov.uk) Data will not be used or shared for any commercial or marketing purposes. At all times your information will be kept securely, and nobody will have access to it that shouldn’t. You can remove your consent at any time. You can do this by contacting SPFcompliance@truro-penwith.ac.uk. I confirm that I have been provided with the information regarding the lawful basis for the data processing, the retention periods for the personal data and the rights available to individuals in respect of the processing.

My personal data will not be shared for any purposes other than the provision of support on offer via SPF Digital Futures Cornwall. I am aware that Truro and Penwith College provides courses that are directly or indirectly part-financed by the UK Shared Prosperity Fund. Where I have ticked `prefer not to say’, I can confirm that I have been asked to answer the question(s) but refused to provide the information.

I acknowledge the privacy statement

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