BOOKING: Level 2 Youth Work Practice Bitesize Accredited Training
Your Details
First Name
Family Name
Address
Email
Telephone
Mobile
Date of Birth
Postcode
Which units do you want to book on to?
Name of Unit
Date
Understanding Youth Work
4th and 5th of December
Principles and Practice (QCF)
2012
Supporting the Provision of
15th and 16th of January
Information and Advice to Young
2013
People (QCF)
Safeguarding Young People in a
12th and 13th of February
Youth Work Setting (QCF)
2013
Please tick as appropriate:
Additional Information:
Disabilities and Learning Difficulties
Yes No 
Would you describe yourself as having a disability
(If yes, please tick the relevant box below)
Visual Impairment

Behavioural Difficulties 
Hearing Impairment 
Disability affecting Mobility
Mental Health 
Other Disability  Please specify _______________________
Would you describe yourself as having a learning difficulty
Yes No 
(If yes, please tick the relevant box below)
Speech and Language difficulty 
Dyslexia 
Other difficulty
Reading difficulty


Writing difficulty 
Please specify _______________________

What is the highest level of qualification you already have?
No formal qualifications 
RSA 1 
Entry level or below

Level 2 eg GCSE grades A-C RSA 2
Level 1 eg GCSE grades D-G,
 Level 3 eg A Level, RSA 3 
Level 4, Degree or higher 
Please note: We ask you for all this information so we can make sure you are on the right
learning programme and we can make adjustments to the courses / materials / assessments
as appropriate.
Have you done any youth work training in the past?
Which club or project do you support at the moment?
Where did you hear about NYY Training?
Lunch and refreshments will be provided. Do you have any dietary requirements?
Costs:
Please tick the appropriate fees for the unit / units you are booking on to.
Status with
Accreditation
Course fee
Total
NYY
registration
NYY Member £25
£0
club
For each
Other
£25
£100
unit
NYY Member £60
£0
For all 3
club
units
Other
£60
£240
Basic self catered accommodation at Carlton Lodge can be
booked for £15 per night.
Total payment:
£25
£125
£60
£300
£
£
Please tick
as
appropriate
Payment:


I have included a cheque payable to North Yorkshire Youth for £
Please send an invoice to:
Name:
Address:
Purchase order number (if appropriate):
Declaration: To the best of my knowledge the details above are correct. I understand that if I
fail to attend the course or cancel my place within 48 hours then a course fee of £100 per
unit will be charged. I also understand that my details will be passed to appropriate parties,
such as awarding bodies or funders, in order to register accreditation and claim funding.
NYY will not pass or sell on your details to any third party, and we will keep your information
safe.
Signature:
Date: