42ndStreet Training Application form
Fill in Black Ink Using Black Capitals
A SEPARATE FORM IS REQUIRED FOR EACH TRAINING COURSE
Name: / Occupation/Job Title:
Group/Organisation:
Address:
Post code: / Tel No:
Fax No:
Mobile:
Email:
Management Approval: / Print Name / Signature / Date
I confirm that I support this application. I will ensure the applicant is freed from his/her normal duties in order to attend.
NB: If you require more than two individuals from your organisation to attend a particular training, please contact us.
Managers email:
How did you find out about this course? (Please tick) / Via Email Marketing Via colleague/Line Manager Self Inquiry
Contacted by Course Trainer 42nd Street Website Poster/Flyer
Other Please state:
Special Needs Requirements
In order to help us to plan appropriate aids and adaptations to enable staff with a disability to attend training courses, please state in the box below any equipment or help you may require. E.g. mobility requirements, portable loop system; electronic handouts; handouts printed on coloured paper; Braille etc
Reason for Applying: (provided to trainers prior to the course to allow them to gain an understanding of your need and where possible to best tailor the course to your requirements)
Payment: Training is free for staff from the voluntary sector. Please provide Charity no:
Training is available to Statutory staff at a cost of £95 for full day training and £60 for half day training.
Please make cheques payable to : 42nd Street NOTE: LUNCH WILL NOT BE PROVIDED
There will be a cancellation fee of £30.00 for non-attendance
For Course Enquires:
Please contact Champa Vaghji or Chris Jacob on 0161 832 0169 / For Booking Enquiries:
Please contact Champa Vaghji on 0161 832 0169
Or email Champa at
The SPACE, 42nd Street, 87-91 Great Ancoats Street,Manchester, M4 5AG