Course/Funding Application

First Name: *

Middle Name:

Last Name: *

Date of Birth: *

Sex: *

Male
Female

E-mail: *

Phone: *

Preferred start date

Preferred course time *

Morning: 9am - 12.30pm
Afternoon: 1pm - 4.30pm
Evening: 5pm - 8.30pm
No preference

Employment status *

Unemployed
Student - Part Time
Student - Full Time
Employed - Part Time
Employed - Full Time

Earnings *

Less than £26,000pa (Required for funding)
More than £26,000
Prefer not to say

Practical Experience Training in IT