Training application form

Law Centre (NI)

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LAW CENTRE (NI)

TRAINING APPLICATION FORM

This form must be completed by the individual who is requesting a place (photocopy additional forms if necessary).

COURSE TITLE:	................................................................................
APPLICANT'S NAME:	................................................................................
JOB TITLE:	................................................................................
ORGANISATION:	................................................................................
ADDRESS (including post code):	................................................................................ ................................................................................ ................................................................................
TELEPHONE:	................................................................................

In what capacity are you employed?

Permanent	o
Short Term Contract	o Please specify duration of contract ..............years..............months
Employment Scheme (eg Worktrack)	o
Volunteer	o

How many hours per week do you work? ................

How many hours per week do you spend on advice work?

1-7	o
7-14	o
14-21	o
21-28	o
28-35	o

Other (please specify) …………..

How long have you been in your present post?

……………… years ……………. months

How long have you been involved in advice work?

……………… years ……………. months

Please give a brief description of your duties in your present post:

..........................................................................................................................…

......................................................................................................................………

Which one of the following best describes the area of work you are involved in (please tick one box):

Advice	o
Information	o
Development	o
Welfare	o
Admin/Clerical	o
Community	o
Training	o
Management	o

Please tick all the boxes which correspond in:

A: the areas of advice work currently undertaken by you

B: the areas of advice work currently undertaken by your organisation

	A	B
Income Support	o	o
Housing Benefit	o	o
Social Fund	o	o
Tax Credits	o	o
Debt	o	o
DLA/AA	o	o
Incapacity Benefit	o	o
Housing	o	o
Employment	o	o

Other: (please specify) …………………………………

Please give a brief account of your interest in this course:

..........................................................................................................................…

............................................................................................................................

Have you previously attended a Law Centre (NI) Basic Welfare Rights, Certificate in Welfare Rights or similar course?

Yes	o
No	o

If yes please state which course and when:

...........................................................................................................................

Are you registered disabled?

Yes	o
No	o

Are you a:

Member voluntary o

Non-member voluntary o

Member statutory/private o

Non-member statutory/private o

Payment enclosed:

Yes o

No o

Signature of Applicant: ______________________________

Date: ______________________________

Signature of Manager

(for accredited courses): ______________________________

Date: ______________________________

PLEASE ENSURE THAT YOU HAVE COMPLETED ALL SECTIONS OF THIS FORM AS INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.

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Disclaimer

Although every effort is made to ensure the information on these pages is accurate and up-to-date, we cannot be held liable for any inaccuracies and their consequences. The information should not be treated as a complete and authoritative statement of the law. When reading articles posted on this site, please pay attention to their date of publication as legislation may have changed since they were published.

Law Centre (NI) only operates within Northern Ireland and the information on this website is only relevant to Northern Ireland law.

As a referral agency, our advice line and other services are only available to members and associate members. First points of contact for the general public for advice on welfare rights should be your local Citizens Advice Bureau or independent advice centre.

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Last Modified: 16 July 2008