PLEASE COMPLETE ALL RELEVANT SECTIONS. SECTION 1 & 4 ARE MANDATORY AND MUST BE FILLED OUT. you Please email the completed form to: For an up-to-date training course directory please visit: SECTION 1: RELEVANT INFORMATION ABOUT YOU. Please complete all fields in this section unless otherwise indicated. Job Role Title Forename Surname Place of Work Full Work Address Work Postcode Telephone Mobile (Optional) Work Email Address SECTION 2: DIVERSITY MONITORING Please select the relevant options. All fields have a not to say’ option. ‘Prefer Ethnicity Date of Birth OR Age Band Gender Transgender: Is your gender identity the same as the gender you were born with? Sexual Orientation Religion Disability Under the Disability Discrimination Act 1995 a person is considered to have a disability if s/he has a physical or mental impairment which has a sustained and long-term adverse effect on his/her ability to carry out normal day to day activities. Since 2005, people with HIV, cancer and multiple sclerosis (MS) are covered by the DDA. If YES, please the type of impairment that applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please select and ‘Other’ specify the type of impairment in the box below.
PLEASE COMPLETE ALL RELEVANT SECTIONS. SECTION 1 & 4 ARE MANDATORY AND MUST BE FILLED OUT. you Please email the completed form to: For an up-to-date training course directory please visit: SECTION 1: RELEVANT INFORMATION ABOUT YOU. Please complete all fields in this section unless otherwise indicated. Job Role Title Forename Surname Place of Work Full Work Address Work Postcode Telephone Mobile (Optional) Work Email Address SECTION 2: DIVERSITY MONITORING Please select the relevant options. All fields have a ‘Prefer not to say’ option. Ethnicity Date of Birth OR Age Band Gender Transgender: Is your gender identity the same as the gender you were born with? Sexual Orientation Religion Disability Under the Disability Discrimination Act 1995 a person is considered to have a disability if s/he has a physical or mental impairment which has a sustained and long-term adverse effect on his/her ability to carry out normal day to day activities. Since 2005, people with HIV, cancer and multiple sclerosis (MS) are covered by the DDA. If YES, please the type of impairment that applies to you. People may experience more than one type of impairment, in which case you may indicate more than one. If none of the categories apply, please select ‘Other’ and specify the type of impairment in the box below.
New_Registration_Form_EYTraining_2018.docx