Youth Federation Booking Form
Course Information
Course
Safeguarding and Child Protection Training
Venue
Bridge Foyer Your Housing, Tower Road, Chester, Cheshire, CH1 4JR.
Area
Cheshire East
Cheshire West
Halton
Warrington
Wirral
Personal Information
Name
Date of Birth
Gender
Male
Female
Address
Postcode
Tel Number
Email
Organisation
Emergency
Name
Contact
Contact Number
Do you have a disability or medical condition that we should be aware of? Yes No
If Yes! please state
Do you need anything that will assist you in your learning? E.g. Audio loop/ large print handouts/
learning buddy Yes
No
If Yes please state
Do you hold a DBS
issued within the last
3 years?
Rate your knowledge of the subject you are booking
on to…


1
2
3
4
5
Yes
No
Please indicate your employment Status:
EmployedF/T
EmployedP/T
Self
Employed
Economically
Inactive i.e. retired
Education or
Training
Have you been permanently resident in England for the last 3
years? If no please complete a residency eligibility form.
Have you been mandated by Job Centre?
Version v2
Volunteer
Unemployed
Yes
No
Yes
No
Youth Federation Booking Form
Please indicate which one you feel best describes your ethnic origin:
White
English
Welsh
Mixed/Multiple
Ethnic Group
White and
Black
Caribbean
White and
Black African
Asian/Asian British
Indian
Black/African/
Caribbean/Black British
African
Other Ethnic
Group
Arab
Pakistani
Caribbean
Any other
Ethnic
Group
Any other
black/African/Caribbea
n Background
Scottish
White and
Asian
Bangladeshi
Northern
Irish
Any other
mixed/multiple
ethnic
Background
Chinese
British
Any Other
Asian
Background
Irish
Gypsy or
Irish
Traveller
Any other
White
Background
Signed:
Date:
Please return your details by Email (if possible) to: training@youthfed.org
Reply electronically with this booking form and this will be accepted as your application. We shall
confirm your place through E-mail.
The majority of our training is FREE to the learners and space are limited. Therefore failure to
notify us of non-attendance 72 hours prior to the course will incur a £50 registration fee to cover
our losses
Cheshire West
Cheshire East
Halton & Warrington
Wirral
Version v2
Jade Dawe
Ann-Marie Morgan
Leigh Allen
Hayley Briggs
jaded@youthfed.org
annmariem@youthfed.org
Leigha@youthfed.org
Hayleyb@youthfed.org
0783 711 0953
0791 240 1440
0796 499 8477
0789 133 0335