Application Form

Please download this form and complete using Microsoft Word, save the document and attach to the mail back form, alternatively email back to

I am applying for an Apprenticeship in / Ref
First Name(s)
Surname
Address
Postcode
Home Contact Number
Mobile Contact Number
E-mail Address
Date of Birth / Age Now
National Insurance Number
Sex / Male / Female
Are you a UK resident / Yes / No
Do you hold a current UK driving license / Yes / No / Provisional
What are you currently doing? / School / College / In Employment / Unemployed / Other
Ethnicity(please circle or highlight)
White – English/Welsh/Scottish / White –
Irish / White –
Gypsy/Traveller / WhiteOther
Mixed/Multi –
White Caribbean / Mixed/Multi –
Black African / Mixed/Multi –
White Asian / Mixed/Multi –
Other
Asian/Asian British –
Indian / Asian/Asian British – Pakistani / Asian/Asian British – Bangladeshi / Asian/Asian British – Chinese
Asian/Asian British – Chinese / Asian/Asian British –
Other / Black/African –
Caribbean / Black/African –
British African
Black/African –
British Caribbean / Black/African –
Other / Arab / Any Other
Are you currently employed and wish to train as an Apprentice? If so please give the name, address and telephone of your employer.
School Attending / Last Attended
School Leaving Date
Qualifications Achieved(please list all qualifications achieved, GCSEs, Key Skills, Functional Skills, NVQs, Awards etc)
Qualification Title / Level / Grade / Actual / Predicted / GCSE
(please tick) / Other(please tick) / Date Achieved
Mathematics
English
ICT
Vocational Qualifications achieved through College or Further Education
Do you have any records of achievements, testimonials, references from school, college or employment? If yes please attach copies to this application.
Have you applied to any other training providers, college or the Armed Forces recently? YES / NO
If yes, what was the outcome
Have you done any part-time work (paid or voluntary), been on work experience or had any other vocational training?
Please explain why you are applying for an Apprenticeship in this vocational area, include a sentence about what type of jobs you feel you may be asked to do.
Did you receive any additional learning support at school or college and if so, please describe what it was for? We may be able to offer some support during your Apprenticeship Programme.
Will you require any adjustments to be made if you are invited in for interview and assessment? For example access to Milltech premises, having materials adjusted etc.
Do you have any Criminal Record or Convictions?
YES / NO
What are your hobbies and interests?
How did you hear about Milltech ?

I declare that the information I have provided is a true record.

Signed ______Date __ / __ / __

Milltech Training LTD - Victoria House - Toward Road

Sunderland - Tyne and Wear - SR1 2QF

Telephone 0191 5100414 Fax 0191 5100424

Email: Website:

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MT0049 / Application Form / May 2013