Course Enrolment Form If you are human, leave this field blank. Please complete the form below to reserve your space. Please also choose your preferred payment/funding option and a tutor will be in touch to take you through the final steps. We look forward to working with you! What type of course do you want to enrol on? * Fitness & Sports Apprenticeships Security Business Apprenticeships Education Please select your fitness course: * Please choose: Diploma in Personal Training Advanced Diploma in Personal Training Ultimate Diploma in Personal Training On-line Diploma in Personal Training Level 4 Strength & Conditioning Gym Instructor Sports Massage On-line Sports Massage Diploma Advanced Apprentice Pathway 1 Advanced Apprentice Pathway 2 Exercise Referral On-line Exercise Referral Level 4 Low Back Pain On-line Lvl 4 Low Back Pain Circuit Trainer Kettlebells Instructor Suspension Trainers Instructor Please select your security course: * Please choose: Door Supervisor Security Guard Please select your business & psychology course: * Please choose: Internal Quality Assurance (Lvl4) Business Administration (Lvl2/3) Customer Service (Lvl2/3) Management (Lvl2/3) Psychology (Access to HE) Please select your education course: * Please choose: Award in Education and Training Certificate in Education and Training Assessors Award (Lvl 3) Preferred funding/payment option: * Please choose: TVA Student Loans Facility Government 19+ Student Loan Student Budget Account Apprenticeship Pay Upfront (prompt payment discount) When do you intend to start: * The next available course A course within the next 3 months A course within the next 6 months A course staring after 6 months time Choose which best suits your intended start date. Please tell us how you heard about us: * Please choose: Google or other search engine Facebook or other social media" Reed Couses Hortcourses Floodlight Courses Plus Other course provider listing Word of mouth Other Please tell us how you heard about us: Your Details: First Name * Surname * Address * Postcode * Email * Phone Number * Date of Birth * Do you live in South East England? If so, please select: Please select: Essex Kent East London West London North London South London National Insurance Number Gender * Male Female Are you a UK Citizen and have been resident for 5 years or more? * Yes No If 'No', you will not be eligible for funding. Prior Qualifications: * Please indicate the Subject, Level of Study, Grade and date achieved. If none, put 'None' in the box. Please indicate your ethnicity: * English/Welsh/Scottish/British Irish Gypsy or Irish Traveller Any other White Background White and Black African White and Black Caribbean White and Asian Any other mixed/multiple ethnic background Indian Pakistani Bangladeshi Chinese Any other Asian Background African Caribbean Any other Black/African/Caribbean Background Arab Any other Ethnic Group Not Provided We are required to obtain this information to monitor our equality and diversity policy. Support Requirements * NONE Visual Impairment Hearing Impairment Disability Affecting Mobility Other Physical Disability Other Medical Condition Social and Emotional Difficulties Mental Health Difficulty Temporary Disability after Illness or Accident Moderate Learning Difficulty Severe Learning Difficulty Dyslexia Dyscalculia Other Specific Learning Difficulty Autism Spectrum Disorder Other Learning Difficulty Profound Complex Disability Asperger's Syndrome Not Provided OtherOther Household Situation * No member of the household in which I live (including myself) is employed The household that I live in includes only one adult aged 18 or over There are on or more dependent children in household Lone or Teenage parent Carer or Care Leaver None of these statements apply I confirm I wish to Withhold this information I confirm all the details given in this enrolment form are true * Yes By clicking submit you are confirming your space on the agreed course you wish to attend. Meaning that you have filled a space that cannot be re-allocated to another student without sufficient time of at least 4 weeks (28 days). Therefore, by providing your second e-signature you agree to The Vocational Academy and Essex Fitness Academy's terms and conditions. By clicking submit, you are taking a space on the agreed course, meaning you need to give 4 weeks notice before the start date should you wish to withdraw your enrolment. Your Agreement: I fully understand that by withdrawing after this timeframe; less than 28 days notice; before induction, or at any time after the induction, will incur course fees as outlined in the academy terms and conditions. Clear Today's Date Send