Online application for taught courses

* Required fields are marked with a red asterisk. 

Course applied for: *
Date of Course *
Venue *
First Name *
Surname *
Job Title *
Orginisation *
Orginisation Name:
(If Other or Coluntary sector/community)
Work Address *

Work Postcode *
Contact Telephone *
Email *
Contact Address
(If different to home address)

Special Needs:
Manager's Name *
Manager's Telephone *
Manager's Email *
Please tick to confirm you understand that if you are offered a place and do not attend without prior notice, your agency may be liable to a fee.

I understand the terms: *


Data Protection Act 1998:
Please note that in accordance with the Data Protection Act 1998 details given in relation to training will only be used for analysis, evaluation, monitoring and statistical purposes. This information may be shared with other agencies in connection with South Tees LSCB activities, plans and policies.