First Name *

Last Name *

Email *

Phone *

I agree to terms & conditions provided by the company. By providing my phone number, I agree to receive text messages from the business.

Date of birth *

Address *

City *

Postal code *

How old were you on the 31st August 2023? *

18 or younger

19 to 23

24 or older

Do you hold a full Level 2 qualification? (Example of Level 2 is 5 GCSE Grade A C/9-4) *

• Yes
• No
• No elements found. Consider changing the search query.
• List is empty.

Have you lived within the UK or EU for the last 3 consecutive years? *

Yes

No

Which area do you live in? *

Nottinghamshire

Derbyshire

None of the above

You must live in Nottinghamshire or Derbyshire to be eligible for this opportunity.

Are you both unemployed and also claiming benefits? *

Yes

No

You need to be unemployed and claiming benefits to be eligible for this course. If you are unemployed and NOT claiming benefits, you will not be eligible.

Please tick the primary income-based benefits you are claiming *

Income Support

Working Tax Credit or Disabled Persons Tax Credit

Universal Credit

Contribution Based Job Seekers Allowance where student is unemployed.

Pensions Tax Credit, where guaranteed

Income Based Job Seekers Allowance

Disability Living Allowing (or the Personal Independence Payments, PIP)

Employment Support Allowance

Universal Credit (as a replacement for ESA) in their own right

Housing/Council Tax Benefit

Can you provide proof of your address? (Evidence will be required, must be dated within the last 3 months) *

Yes

No

Do you have in date photo ID e.g. Passport, Driving Licence, Citizen card? (If NO, please apply for your Citizen Card by the time your course starts for all Rail courses) *

• Yes
• No
• No elements found. Consider changing the search query.
• List is empty.

This programme is now fully booked. Would you like to be placed on a waiting list for future courses or in case of drop-outs? *

Yes

No

Strict email filters mean that its highly likely that our emails to you may end up in your junk or spam folders. They may even get blocked all together. Can you agree to add [email protected] to your email contacts to avoid this? *

Yes - I want to receive confirmation and reminders about this opportunity

No - I'll take my chances / i'm not that serious

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