Learning Agreement - QN1919F - ESOL Conversation Class E3/L1 - Skills & Learning Adult Community Education

Course Code*

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Course Tutor*

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Course Venue*

Course Title:*

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Primary Learning Aim

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Learning Aim Title*

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Start Date*

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Planned End Date*

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GLH*

Name*

Title Given Name Family Name

Preferred Pronouns

Previous Family Name

Sex*

Male

Female

Date of Birth*

Address*

Street Address Address Line 2 Town Post Code

Main Contact Number*

Alternative Contact Number

Email Address

Emergency Contact Name

Emergency Contact Number

Ethnic Origin*

Do you have a disability and/or learning difficulty?*

Yes

No

Do you have an EHCP (Education Health Care Plan)

If you are aged 18-24, please confirm whether you have an Education Health Care Plan.

Yes

No

Learning Support

If you consider yourself to have a disability or learning difficulty please tick any that apply.

Primary disability or learning difficulty

If you have ticked more than one option in the previous question, please select which of these you think will have the biggest impact on your course.

Support contact request*

If you have indicated a medical condition, disability and/or learning difficulty, would you like us to contact you to discuss your additional support requirements?

Yes

No

Are you a UK national?*

Yes

No

Have you been a permanent resident in the UK for at least the last 3 years?*

Yes

No

If you have not previously completed our learner residency declaration since 1st July 2021 you will need to do so. This declaration can be found at, https://www.skillsandlearningace.com/learner-residency. You will need to provide evidence of your residency and if you are the dependent of someone else then evidence of theirs.

Evidence of identification

To verify your identification please upload a scanned image or photograph of one of the following forms of ID, including but not limited to: passport, driving licence, ID card or other national identification.

Accepted file types: jpg, jpeg, png, pdf, Max. file size: 10 MB.

How we (S&L) use your Personal Information

Skills & Learning is compliant with Data Protection legislation and some of the information on this form will be disclosed to certain Government Agencies as requested such as the Department for Education (DfE). A copy of our privacy statement is available on our website, https://www.skillsandlearningace.com/policies/privacy/. You can request a copy of this document in an alternative format by contacting enquiries@salbcp.com or 01202 123444.

How the Education & Skills Funding Agency use your Personal Information

This privacy notice is issued by the Education and Skills Funding Agency (ESFA) on behalf of the Secretary of State for the Department of Education (DfE) to inform learners about the Individualised Learner Record (ILR) and how their personal information is used in the ILR. Your personal information is used by the DfE to exercise our functions under article 6(1)(e) of the UK GDPR and to meet our statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009. Our lawful basis for using your special category personal data is covered under Substantial Public Interest based in law (Article 9(2)(g)) of GDPR legislation. This processing is under Section 54 of the Further and Higher Education Act (1992).

The ILR collects data about learners and learning undertaken. Publicly funded colleges, training organisations, local authorities, and employers (FE providers) must collect and return the data to the ESFA each year under the terms of a funding agreement, contract or grant agreement. It helps ensure that public money distributed through the ESFA is being spent in line with government targets. It is also used for education, training, employment, and well-being purposes, including research.

We retain your ILR learner data for 20 years for operational purposes (e.g. to fund your learning and to publish official statistics). Your personal data is then retained in our research databases until you are aged 80 years so that it can be used for long-term research purposes. For more information about the ILR and the data collected, please see the ILR specification at https://www.gov.uk/government/collections/individualised-learner-record-ilr.

ILR data is shared with third parties where it complies with DfE data sharing procedures and where the law allows it. The DfE and the English European Social Fund (ESF) Managing Authority (or agents acting on their behalf) may contact learners to carry out research and evaluation to inform the effectiveness of training.

For more information about how your personal data is used and your individual rights, please see the DfE Personal Information Charter (https://www.gov.uk/government/organisations/department-for-education/about/personal-information-charter) and the DfE Privacy Notice (https://www.gov.uk/government/publications/privacy-notice-for-key-stage-5-and-adult-education).

If you would like to get in touch with us or request a copy of the personal information DfE holds about you, you can contact the DfE in the following ways:

Using our online contact form https://form.education.gov.uk/service/Contact_the_Department_for_Education.

By telephoning the DfE Helpline on 0370 000 2288

Or in writing to – Data Protection Officer, Department for Education (B2.28), 7 & 8 Wellington Place, Wellington Street, Leeds, LS1 4AW

If you are unhappy with how we have used your personal data, you can complain to the Information Commissioner’s Office (ICO) at: Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF. You can also call their helpline on 0303 123 1113 or visit https://www.ico.org.uk.

The information you supply is used by the Education and Skills Funding Agency (ESFA), an executive agency of the DfE, to issue you with a Unique Learner Number (ULN) and to create your Personal Learning Record on the Learning Records Service, as part of the functions of the DfE. The Learning Records Service Privacy notice is available at https://www.gov.uk/government/publications/lrs-privacy-notices/lrs-privacy-notice.

Data Protection and Privacy Notice Confirmation*

I have read and understood this data protection and privacy notice.

Contact Preferences We (or the Education & Skills Funding Agency) would like to send you information about our courses, learning opportunities and for surveys and research by post, telephone or email. If you agree to being contacted in this way please tick the relevant box(es) below:

Reason for contact

About courses or learning opportunities

For surveys and research

How contact is allowed

Preferred method of contact?

By post

By phone

By e-mail

We will use the contact details held to contact you with information relating to your course(s).

How did you hear about us?

Learner Declaration

I confirm that

The personal information I have provided is correct and that I am not studying this course with another provider.
I understand that if I have declared false information Skills & Learning may take action against me to reclaim fees and any support costs provided.
I am aware my details will be sent to the Learner Registration Service and used to create and maintain a Unique Learner Number and Personal Learning Record.
I have read and understood the Skills & Learning Terms and Conditions https://www.skillsandlearningace.com/terms-and-conditions (opens in a popup window).
I have received sufficient information and guidance about the course I am going to do and believe it is at the right level for me.

I agree that

I will inform Skills & Learning of any unspent criminal convictions (please refer to Learner Handbook for guidance).
I will complete the course detailed above and undertake the work required.
I will sit the exam/assessment required to achieve the qualification (if applicable) and submit all required coursework.
I will undertake independent study and homework to help me progress quickly.
I will attend regularly and arrive on time.
I will inform Skills & Learning if I am unable to attend.
Attendance will be monitored and if I miss 3 sessions in a row, or 2 in a term, I will be contacted for a discussion which may result in being withdrawn from the course.
I will help support the future funding of adult learning by providing feedback on the impact of having undertaking this learning programme.

Signature*

Please draw your signature either with your mouse or if you have a touchscreen with your finger or stylus.

Date*

Signing above confirms that the declarations you have made in this form are a true and accurate reflection of your circumstances.

Learning Agreement – QN1919F – ESOL Conversation Class E3/L1

Primary Learning Aim

Access to ICT & Digital Skills

How we (S&L) use your Personal Information

How the Education & Skills Funding Agency use your Personal Information

Learner Declaration

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