PTLLS Application Form

If you would prefer to download a printable copy of this form please click here.

Specific Course Dates Applying For:
Date of Application:
Name:
Title:
Age:
Date of Birth (Minimum age 19):
Home Address:
Postcode:
Home telephone Number:
Work telephone Number:
Mobile telephone Number:
Email Address:
Gender:	Male Female
NI Number:
Nationality:
Date of Entry to the UK:
Normal Country of Residence:
Have you been ordinarily resident in the UK for the last 3 years?	Yes No
Employer Name:
Type of Organisation:
Workplace contact name and telephone number for fees:(if applicable)
Who will be paying the fees?	Me My Employer
What teaching, tutoring or assessing qualifications do you have?
What subjects will you be teaching?
And what qualifications fo you have in these subjects?
To do this course you need to have English, Maths and IT skills at Level 2. Do you have these?	Yes No
How long have you been teaching/training?
What subject areas do you teach/train in?
Do you anticipate any particular challenges that we could help you with?
Please use this space to indicate any special learning requirements you may have.
Lunch and refreshments are provided; do you have any special dietary requirements?
Please copy the 6 letters from the image captcha.