PICS Learner Management System : Applicant Sign Up : Apprenticeship Application Form - Candidates who are employed and currently working in the industry.

Apprenticeship Application Form - Candidates who are employed and currently working in the industry.

Learner Details

Title *

First Names *

Surname *

Date of Birth *

Sex *

Mobile *

Email *

NI Number *

Address *

Address 2

Postcode *

Ethnicity *

Disabilities & Learning Difficulties

Do you have any disabilities? *

If yes, please select all that apply

If yes, please select your primary disability from the list

Next of Kin (Must be a parent/guardian if under 18)

Next of Kin Name *

Next of Kin Relationship *

Next of Kin Phone *

Employment Details

Employment Status *

Employer Name *

Employer Contact Email *

Employer Contact Number *

Employer Address 1 *

Employer Address 2 *

Employer Postcode *

Please upload a copy of your current job description so we can ensure this apprenticeship is suitable for you.

Drop files here or click to browse.

Apprenticeship Details

Apprenticeship Type *

Delivery Location *

Education & Prior Qualifications

Name of High School *

Name of College or Sixth Form *

GCSE Maths Grade

GCSE English Grade

Eligibility Criteria

I am normally and lawfully resident in the UK and have been for the last 3 years. *

Yes
No

I am legally entitled to live and work in the United Kingdom. *

Yes
No

I have not been resident in the UK, but I fulfil the residency criteria and have provided the required evidence to confirm my status. *

Yes
No
N/A

Are there any immigration restrictions on how long you can stay in the UK? *

Yes
No
N/A

Do you live in England? *

Do you work in England? *

Household Situation

Please select your household situation from the list *

Contact Methods

SIMIAN is committed to protecting your privacy and your personal data. The data captured on this form may be used to create an apprenticeship learner record and may be passed onto the Education and Skills Funding Agency (ESFA). Your personal data is used by the ESFA, the Department for Education and any successor organisations to exercise their functions and responsibilities under the Apprenticeships, Skills, Children and Learning Act 2009 and to create and maintain a unique learner number (ULN) and a Personal Learning Record (PLR). Your information will be securely destroyed after it is no longer required for these purposes.

You may be contacted by the Department of Education, the Education and Skills Funding Agency or agents acting on their behalf in order for them to carry out surveys and research and inform you about learning opportunities. Please select the options you agree to be contacted by below.

Please select all available methods of contacting you *

Of the above, please select the preferred contact method *

Declaration

By pressing 'Submit' you confirm the following:

The information on this form is correct to the best of my knowledge.
I declare that I have correctly identified my prior qualifications.
I have a contract of employment (where applicable).
I agree to inform SIMIAN of any relevant changes of details and personal circumstances.
I consent to Simian processing my information in accordance with Data Protection Legislation.
I agree to allow Simian to access my Personal Learning Record to verify my prior learning.
I consent to the personal information I have provided being passed to the Chief Executive of the Education and Skills Funding Agency (ESFA) to meet legal duties under the Apprenticeship, Skills, Children and Learning Act 2009, and for the ESFA’s Learning Records Services (LRS) to create and maintain a unique learner number (ULN).

Submit

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