Level 3 Diploma in Veterinary Nursing
Level 3 Diploma in Veterinary Nursing Assistant
All in one Student Register
Student
Enrolment
First Name
*
Last Name
*
Email Address
*
Mobile
*
Description
Application Form
Which month do you wish to start the course? Select more than one box if you are flexible
*
--None--
January
April
September
Learner Details
Prefix
*
--None--
Mr.
Ms.
Mrs.
Miss
Dr.
Prof.
Other
First Name
*
Middle Name
Last Name
*
Date of Birth
*
Gender
*
--None--
Female
Male
Other
Prefer not to say
Transgender
Primary Address
*
Primary City
*
Primary State
*
Primary Postal Code
*
Primary Address Country
*
Prior Postcode
*
Mobile Phone
*
Email Address(es)
*
National Insurance Number
*
Emergency Contact Details
Primary NOK Name
*
Primary NOK Mobile Number
*
Primary NOK Email
*
Eligibility
Do you have the right to work in the United Kingdom?
*
--None--
Yes
No
What is your place (country) of birth
*
Nationality on Passport
*
In which country do you normally live?
*
If you are, or have been, living overseas please state your date of entry into the UK
*
Have you been resident in the UK/EEA (European Economic Area) for the last 3 years?
*
--None--
Yes
No
If No to questions above, are you a non-EEA citizen with permission from the UK government to live in the UK, (not for educational purposes) and have been ordinarily resident in the UK for at least the previous three years before the start of learning
*
--None--
Yes
No
If NO to all above, please discuss with your tutor your eligibility for funding. Reasons and evidence seen for eligibility
*
Will You Spend At Least 50% Of Your Working Hours In England Or Wales Over The Duration Of The Apprenticeship?
*
--None--
England
Wales
Household Situation (for ESFA purposes), please tick appropriate box
*
--None--
No household member is in employment and the household includes one or more dependent children
No household member is in employment and the household does not have any dependent children
Learner lives in a single adult household with dependent children
Learner has withheld this information
None apply to me
Application Form
Please select which course you are applying for:
*
--None--
L3 Veterinary Nurse Diploma
L3 Veterinary Nurse Diploma Apprentice
L2 Veterinary Nursing Assistant Diploma
Which month do you wish to start the course? Select more than one box if you are flexible
*
--None--
January
April
September
Learner Details
Prefix
*
--None--
Mr.
Ms.
Mrs.
Miss
Dr.
Prof.
Other
First Name
*
Middle Name
Last Name
*
Date of Birth
*
Gender
*
--None--
Female
Male
Other
Prefer not to say
Transgender
Primary Address
*
Primary City
*
Primary State
*
Primary Postal Code
*
Primary Address Country
*
Prior Postcode
*
Mobile Phone
*
Email Address(es)
*
National Insurance Number
*
Emergency Contact Details
Primary NOK Name
*
Primary NOK Mobile Number
*
Primary NOK Email
*
Eligibility
Do you have the right to work in the United Kingdom?
*
--None--
Yes
No
What is your place (country) of birth
*
Nationality on Passport
*
In which country do you normally live?
*
If you are, or have been, living overseas please state your date of entry into the UK
*
Have you been resident in the UK/EEA (European Economic Area) for the last 3 years?
*
--None--
Yes
No
If No to questions above, are you a non-EEA citizen with permission from the UK government to live in the UK, (not for educational purposes) and have been ordinarily resident in the UK for at least the previous three years before the start of learning
*
--None--
Yes
No
If NO to all above, please discuss with your tutor your eligibility for funding. Reasons and evidence seen for eligibility
*
Will You Spend At Least 50% Of Your Working Hours In England Or Wales Over The Duration Of The Apprenticeship?
*
--None--
England
Wales
Household Situation (for ESFA purposes), please tick appropriate box
*
--None--
No household member is in employment and the household includes one or more dependent children
No household member is in employment and the household does not have any dependent children
Learner lives in a single adult household with dependent children
Learner has withheld this information
None apply to me
Please answer the questions below
Do you have the right to work in the United Kingdom?
--None--
Yes
No
Are you expected to be employed for at least 51% of your contracted hours in Wales?
--None--
Yes
No
Have you legally left school
--None--
Yes
No
Are you attending school or college full-time as a pupil or student
--None--
Yes
No
Are you in full-time higher education?
--None--
Yes
No
Are you an ineligible overseas national?
--None--
Yes
No
Are you in custody or on remand in custody
--None--
Yes
No
Are you in receipt of an Assembly Learning Grant or Education Maintenance Allowance?
--None--
Yes
No
Are you supported by the UK Government’s Work Programme and have a contract of employment for less than 16 hours per week?
--None--
Yes
No
Are you taking part in any other employment or enterprise programmes funded directly by the UK Government or the Welsh Ministers?
--None--
Yes
No
Are you taking part in any other UK Government or Welsh Ministers funded vocational learning programme?
--None--
Yes
No
Are you taking part in any other EU funded employment or enterprise programme or vocational learning programmes (or any other form of EU funded scheme) unless permitted under ESF funding regulations?
--None--
Yes
No
Are you employed
--None--
Yes
No
Do you have a signed Apprenticeship Learning Agreement
--None--
Yes
No
Are you being paid the relevant National Minimum Wage
--None--
Yes
No
Do you hold a degree AND is the degree you hold in the same occupational route as this Apprenticeship Programme
--None--
Yes
No
Please give details of your highest qualification achieved below
Your Details
ULN
First Name
*
Last Name
*
Primary Address
Primary City
Primary State
Primary Address Country
Primary Postal Code
In which country do you normally live?
Email Address(es)
*
Mobile Phone
NI Number
Date of Birth
Gender
--None--
Female
Male
Other
Prefer not to say
Transgender
Ethnicity
--None--
English / Welsh / Scottish / Northern Irish / British
Irish
Gypsy or Irish Traveller
Any Other White Background
White and Black Caribbean
White and Black African
White and Asian
Any Other Mixed / Multiple ethnic background
Indian
Pakistani
Bangladeshi
Chinese
Any other Asian background
African
Caribbean
Any other Black / African / Caribbean background
Arab
Any Other ethnic group
Not Provided
Other ethnicity
National Identity
--None--
British
English
Irish
Scottish
Welsh
Other
Welsh Speaker Indicator
--None--
Fluent Welsh speaker
Welsh speaker not fluent
Not Welsh speaker
Do you speak Welsh in the workplace
--None--
Yes
No
Previous Learning Establishment
Year left school
Level of highest qualification achieved prior to learning programme
Pre-entry level - 0
CQFW Entry Level - E
CQFW Level 1 (e.g. NVQ Level 1 / GCSE D-G) - 1
CQFW Level 2 (e.g. NVQ Level 2 / GCSE A*-C) - 2
CQFW Level 3 (e.g. NVQ Level 3 / A level) - 3
CQFW Level 4 (e.g. HE Certificate / HNC) - 4
CQFW Level 5 (e.g. HE Intermediate) - 5
CQFW Level 6 / HE Honours - 6
CQFW Level 7 / HE Masters - 7
CQFW Level 8 / HE Doctorate - 8
Employment status at start of programme
*
--None--
Employed
Self Employed
Company Name
*
Company Postcode
*
Migrant Worker Indicator
*
--None--
Learner is a migrant worker (EU)
Learner is a migrant worker (non-EU)
Learner is not a migrant worker or refugee
Learner is a refugee
Information refused
Hours Worked
*
Size of employer
*
--None--
0 – 1 employees
2 - 9 employees
10 – 49 employees
50 – 249 employees
250+ employees
Numeracy
*
--None--
Pre-Entry Level 1
Entry Level 1
Entry Level 2
Entry Level 3
Level 1
Level 2
Level 3
Numeracy assessments completed in
*
--None--
E
B
Literacy
*
--None--
Pre-Entry Level 1
Entry Level 1
Entry Level 2
Entry Level 3
Level 1
Level 2
Level 3
Literacy assessments completed in
*
--None--
E
W
Digital Literacy
*
--None--
Pre-Entry Level 1
Entry Level 1
Entry Level 2
Entry Level 3
Level 1
Level 2
Level 3
Digital literacy assessments completed in
*
--None--
E
B
Referral if Entry 3 or lower only
*
--None--
Declined Support
Accepted Support
Is the learner Employer Incentive
*
--None--
Yes
No
Does the learner intend to progress to level 2
*
--None--
Yes
No
Does the learner intend to progress to level 3 or above
*
--None--
Yes
No
Welsh First Language
*
--None--
Pre Entry Level
Entry Level
Level 1 e.g. GCSE D-G
Level 2 e.g. GCSE A*-C
Level 3 and above e.g. AS, A level
Welsh Second Language
*
--None--
Pre Entry Level
Entry Level
Level 1 e.g. GCSE D-G
Level 2 e.g. GCSE A*-C
Level 3 and above e.g. AS, A level
Length of Employment with same employer
*
Not employed with same employer prior to commencing learning programme
Have been employed in their current job role for less than 3 months
Have been employed in their current job role for 3 months to less than 6 months
Have been employed in their current job role for 6 months to less than 12 months
Have been employed in their current job role for 12 months or more
Not applicable
Start Date
*
ALN Indicator
*
--None--
Learner does not have additional learning needs (ALN)/not required
Learner is receiving additional learning support but ALS funding is not utilised
Learner is receiving additional learning support for which ALS funding is utilised
Planned End Date
*
Household Situation (For Esfa Purposes), Please Tick Appropriate Box
*
--None--
Living in a jobless household
Living in a jobless household with dependent children
Living in a single adult household with dependent children
Homeless or affected by housing exclusion
Any other household
Information refused
Living in a single adult household
Not known
Caring Responsibilities
*
Primary Carer of a child/children (under 18) and Primary Carer of a disabled adult (18 and over) and Primary Carer of older person/people (65 and over)
Primary Carer of a child/children (under 18)
Primary Carer of disabled adult (18 and over)
Primary Carer of older person/people (65 and over)
No caring responsibilities
Information refused
Primary Carer of a child/children (under 18) and Primary Carer of a disabled adult (18 and over)
Primary Carer of a child/children (Under 18) and Primary Carer of older person/people (65 and over)
Primary Carer of a disabled adult (18 and over) Primary Carer of older person/people (65 and over)
Not known
Apprenticeship Levy Indicator
*
--None--
The employer does not contribute to the apprenticeship levy
The employer does contribute to the apprenticeship levy
Gradu8 Ceremony
*
--None--
Yes
No
LLDD Indicator
*
--None--
Learner does not have additional learning needs (ALN) / not required
Learner is receiving additional learning support but ALS funding is not utilised
Learner is receiving additional learning support for which ALS funding is utiliised
