Application for CPD Training Courses

MUST BE COMPLETED AT LEAST ONE WEEK BEFORE COURSE

Course Details

Title of course: / Date(s) of training:
Name: / School:
Email: / Contact telephone number:
Job title:

To gain maximum benefit, discuss the following with your line manager:

  1. Why you are attending the course?
  1. What development objectives do you hope to achieve?
  1. What you would like to be able to do differently/better after attending?
  1. How might you share the learning with your colleagues?

Links to:

School Improvement Plan / Yes  No 
Performance Management / Yes  No 
Specific Subject / Yes  No 
Post holder responsibility / Yes  No 
Leadership and management / Yes  No 

Candidate’s Declaration

The information I have given on this form is correct to the best of my knowledge:

Signed: Date://

By submitting this form, I agree to my details being held on our database under the terms of the Data Protection Act.

Authorisation section (must be a member of SLT):

Signed: Date://

Name: Job Title:

School:

We are committed to ensuring equality for all applicants. We will monitor the profile of those applying for training and the outcomes of those applications by using the information provided below. Information from this form will not be used for any other purposes.

Equal opportunities monitoring form

Ethnicity or Race

To which of these groups do you consider you belong? Please tick one box

Asian or Asian British / Black or Black British
Indian / Caribbean
Pakistani 1 / African 3
Bangladeshi / Black British
Any other Asian Background 2 / Any other Black background 4
Mixed / White
White & Black Caribbean / English
White & Black African / Scottish
White & Asian 5 / Welsh
Black & Asian / Irish
Black & Chinese / Northern Irish
Chinese & White / Eastern European 7
Any other Mixed background 6 / Western European 8
Any other White Background 9
Other Ethnic Group / Chinese 10
Arab
Other 11
Prefer not to say

Disability status12

The council’s Disability Equality Scheme states ‘the problems experienced by many disabled people are not because of their impairments or medical conditions, but are due to attitudinal and environmental barriers. This is known as ‘the social model of disability’.

Do you consider yourself to be disabled as defined by the Social Model? Please tick one box

Yes / No / Prefer not to say

The definition of disability, as outlined in the Disability Discrimination Act 1995 & 2005 (DDA) is as follows: “A physical or mental impairment which has a substantial and long term adverse effect on a person’s ability to carry out normal day-to-day activities”.

Do you consider yourself to be disabled as defined by the DDA? Please tick one box

Yes / No / Prefer not to say
Male / Female

2) Gender

3) Age

Help Notes

The notes below have been developed to provide additional information and examples to help you make your decision/selection.

Ethnicity and Race

1. Mirpuri Pakistani, Other Pakistani, Kashmiri Pakistani.

2. African Asian, Kashmiri Other, Nepali, Sinhalese, Sri Lankan Tamil, Other Asian.

3. Angolan, Congolese, Ghanaian, Nigerian, Sierra Leonian, Somali, Sudanese, other Black African.

4. Black European, Black North American, other Black.

5. White and Pakistani, White and Indian, White and any other Asian background.

6. Asian and Black, Asian and Chinese, Black and any other ethnic group, Chinese and any other ethnic group.

  1. Albanian, Bosnian-Herzegovinian, Croatian, Serbian, Kosovan.
  2. Italian, French, German, Spanish, Greek/Greek Cypriot, Greek, Portuguese.
  3. Australian, New Zealand and South African, Turkish/Turkish Cypriot, Turkish, Turkish Cypriot

10. Hong Kong Chinese, Malaysian Chinese, Singaporean Chinese, Taiwanese, Other Chinese

11. Afghan, Egyptian, Filipino, Iranian, Iraqi, Japanese, Korean, Kurdish, Latin/ South/Central American, Lebanese, Libyan, Malay, Moroccan, Polynesian, Thai, Vietnamese, Yemeni, Any other ethnic group.

12. Disability

The Social Model or definition sees disabled people as having the same wants, needs as non-disabled people, and seeking fair treatment. Barriers experienced may be organisational, personal or physical, for instance, buildings that are difficult to get into, poor, or lacking information, or people’s negative attitudes.

The definition of disability, as outlined in the Disability Discrimination Act (1995 & 2005) is “A physical or mental impairment which has a substantial and long term adverse effect on a person’s ability to carry out normal day-to-day activities”.

To be protected under the Act,

  • An individual must have, or have had, an impairment which can be physical or mental
  • It must have adverse effects which are substantial, that is something more than minor or trivial
  • It needs to be long term, i.e. the impairment has lasted or is likely to last in total for at least twelve months or is likely to last the rest of the life of the person affected

And

  • It must affect day to day activities at work on a regular basis

The effect an impairment may have on day to day activities is defined in the Act as falling within the following categories:-

  • Mobility
  • Manual dexterity
  • Physical co-ordination
  • Continence
/
  • Ability to lift, carry or otherwise move everyday objects
  • Speech, hearing or eyesight
  • Memory or ability to concentrate, learn or understand
  • Perception of the risk of physical danger

Some examples now covered by the DDA include: mental illness or mental health problems, learning disabilities, diabetes, epilepsy, cancer, HIV and MS.

STRICTLY PRIVATE AND CONFIDENTIAL WHEN COMPLETED

The Disability Discrimination Act (DDA) defines a disability as a physical or mental impairment which has a substantial (i.e. more than just trivial or minor) and long term (i.e. which has lasted or is likely to last 12 months or more) adverse effect on a person’s ability to carry out normal day-to-day activities.

Applications must be received at least one week prior to the commencement of the course, using the supplied application form.