How to enrol First select your course. There

Adult & Community Learning • Autumn and Spring 2011/12 •www.surreycc.gov.uk/adultlearning
How to enrol
By Post
First select your course. There
are nearly 2,000 in this brochure, Please complete both sides of the enrolment form.
so if you need more information Enter your debit, credit or switch card details or
attach a cheque (made payable to Surrey County
to decide which one is right for Council) and post to the relevant centre. If paying
you, either check our website or a benefit claimants’ fee, please enclose proof of
receipt of benefit (see back of enrolment form).
give one of our centres a call.
How to Enrol
If you require confirmation of enrolment, please
enclose a stamped, addressed envelope.
Having chosen your course, you By Fax
can enrol by whichever of the
Please complete both sides of the enrolment form.
methods below is most
Enter your payment card details and fax both sides
convenient for you. Please enrol of the form to the relevant centre. If paying a benefit
claimants’ fee, please also fax proof of receipt of
as early as you can, as places are benefit (see back of enrolment form).
limited and popular courses fill If you are enrolling by post or fax, please assume
that your enrolment has been accepted. If there is a
up quickly.
problem processing your form, we will contact you.
In Person
You can pay with credit or debit card, cheque (made
payable to Surrey County Council) or cash.
The fees listed in this brochure are subsidised
by a grant from the Skills Funding Agency. Not
everyone is eligible for these subsidised fees and
we are required to confirm whether or not you
qualify when you enrol.
If you’re paying a benefit claimants’ fee, please bring
proof of receipt of your benefit with you when you
You will qualify for the subsidised fees if you are
aged 19 years or over and:
enrol (see back of enrolment form).
• have been continuously resident in the United
Kingdom (UK) for at least the three years before
the start of your course; or
• are a national of any European Union (EU) country
or are the spouse, civil partner or child of an EU
national and have been continuously resident in
the European Economic Area (EEA) for at least the
three years before the start of your course.
You can enrol in person at any of our centres.
Maps and opening hours are on pages 4 and 5.
By Phone
Please call the relevant centre and have your credit
or debit card details ready.
Telephone lines can be extremely busy during our
main enrolment periods. If you don’t need to speak
to a member our staff, we recommended that you
post or fax your enrolment form. This will help to
free the telephone lines for those with an enquiry.
144
Non-EU residents
If you do not meet the above criteria, you may
have to pay a higher, non-subsidised fee and will
not qualify for our over 60’s or benefit claimants’
discounts. If you think you may fall into this
category, please contact your local centre for more
information and to confirm your fee.
Surrey Adult and Community Learning Enrolment form 2011/12 Also available in large print Personal details (please complete in BLOCK CAPITALS) Mr  Title Learner ID Mrs  Miss  Other ........... Forename Male  Gender Female  Surname Address Date of birth Tel day Tel eve Postcode Email We may contact you about new courses, special offers and should a situation (e.g. bad weather) arise that affects the running of your course. Please tick the following boxes as appropriate if you do not wish to be contacted:  about surveys and research H  about courses or learning opportunities  by post  by email  by telephone Have you been continuously resident in England for the last 3 years? Yes  No  If no are you a European Union (EU) national? Yes  No  Have you been continuously resident in another UK or EU country for the last 3 years? Yes  No  * Please state your previous country of residence: ........................................................................................................................................................ *If you have not been continuously resident in the EU for at least the last 3 years, you may be required to pay a higher fee. Ethnic group White  English/Welsh/Scottish/ Northern Irish/British  Irish  Gypsy or Irish Traveller  any other White background Mixed/multiple ethnic group  White and Black Caribbean  White and Black African  White and Asian  any other Mixed/multiple ethnic background Asian or Asian British Black/African/Caribbean/  Indian Black British  African  Pakistani  Bangladeshi  Caribbean  Chinese  any other Black/African/  any other Asian Caribbean background background Other ethnic group  Arab  any other ethnic group Do you have a learning difficulty, disability or health problem?  Yes ‐ please tick as appropriate below  No  Prefer not to say Disabilities and health problems  visual impairment  hearing impairment  disability affecting mobility  other physical disability  other medical condition (for example epilepsy, asthma, diabetes)  emotional/behavioural difficulties  mental health difficulty  temporary disability after illness (for example post‐viral) or accident  profound complex disabilities  Asperger syndrome  multiple disabilities  other Learning difficulties  moderate learning difficulty  severe learning difficulty  dyslexia  dyscalculia  other specific learning difficulty  autism spectrum disorder  multiple learning difficulties  other What is your highest level of qualification?  No qualifications  Entry level ‐ Certificate in adult literacy, numeracy or ESOL Skills for Life  Level 1 ‐ 5 or more GCSE/O levels at grades D‐G or fewer than 5 at grades A‐C  Level 2 ‐ 5 or more GCSE/O levels at grades A‐C; 5 or more CSE grade 1; 1 A level  Level 3 ‐ 2 or more A level passes; 4 or more AS levels  Level 4 ‐ first degree; HNC; HND; NVQ level 4  Level 5 or above ‐ e.g. higher degree; MA; MSc; PhD  Other qualification, level not known How we use your personal information The personal information you provide is passed to the Chief Executive of Skills Funding (“the Agency”) and, when needed, the Young People’s Learning Agency for England (“the YPLA”) to meet legal duties under the Apprenticeships, Skills, Children and Learning Act 2009, and for the Agency’s Learning Records Service (LRS) to create and maintain a unique learner number (ULN). The information you provide may be shared with other partner organisations for purposes relating to education or training. Further information about use of and access to your personal data, and details of partner organisations are available at: http://skillsfundingagency.bis.gov.uk/privacy.htm http://www.ypla.gov.uk/privacy.htm http://www.learningrecordsservice.org.uk/documentlibrary/documents/Code+of+Practice+for+Sharing+of+Personal+Information.htm Please read and sign I declare that, to the best of my knowledge, the information I have provided on this form is correct. I have read the above statement on personal information and understand that Surrey County Council reserves the right to change tutors, re‐schedule, cancel or combine courses if necessary. Signed:................................................................................................................................................................... Date:........................................................ Please turn over and complete page 2 1 of 2 145
Surrey Adult and Community Learning Enrolment form 2011/12 Course code Course title Fee £ £ £ Adult full  Fee type Over 60  Benefits  Total fee £ Where did you find out about your course?  You’ve learnt with us before  Brochure from Adult Learning Centre  Brochure or poster at Surrey library  Leaflet or brochure delivered to your home  Introduce a friend promotion  Doctor, health centre or health group  Word of mouth  Radio advertisement  Newspaper advertisement  Open day at Adult Learning Centre  County magazine, e.g. Surrey Matters or Jigsaw  Adult Learning website  Other website (please specify): .................................................................................................  Other source not listed above (please specify): ........................................................................ Payments If you’re paying a reduced fee, please complete the ‘Application for discount’ section below Please make cheques payable to SURREY COUNTY COUNCIL and send along with this form to the appropriate centre. For payment by Visa/MasterCard/Switch/Delta/Electron/Solo ‐ I authorise you to charge my Debit/Credit/Switch card number: Amount £ Name on card Signature Valid from Exp date Issue no Security no Date Receipts are normally issued for cash payments only; if required for other methods of payment, please tick here  Office use only Cash Cheque Card S/O Date Receipt no. Application for discount Please complete ONE SECTION only if claiming a discount The following discounts are available on tuition fees for all courses except where the brochure shows the same amount for both the ‘adult’ and the ‘over 60’ fee. To claim a discount, please sign and date the relevant section below and either post, fax or hand‐deliver the completed form to your local centre. We require a signed enrolment form for all discounts, so it is not possible to claim a discount when enrolling by telephone. If you’re claiming the benefits discount, you will need to supply proof of receipt of benefits when you enrol. Section 1 – 60 and over Discount If you are 60 years of age or over and not in full‐time paid employment on the day your course begins, you may claim a 20% discount on your tuition fee. Section 1 – 60 and over Discount I am 60 years of age or over and not in full‐time paid work on the day my course begins. I wish to claim a 20% discount. Signed ...................................................... Date ............................ Section 2 – Benefits Discount If you are in receipt of income‐based benefits including: Council Tax Benefit; Income Support; Housing Benefit; income‐based Job Seekers Allowance; contribution‐based Job Seekers Allowance; Carers Allowance; Pension Credits (Guarantee Credit only); or Working Tax Credit with a gross household annual income of less than £15,860 when you enrol, you may claim a 50% discount on your tuition fees for up to 2 courses at the same time. Section 2 – Benefits Discount I am in receipt of (please state benefit type below): Unwaged partners or dependants of benefits claimants may also claim a 50% discount. Please supply proof of co‐residence when you enrol, e.g. your driving licence or council tax statement. I am the unwaged partner or dependant of a person claiming benefit. We require proof of eligibility for benefit claimants’ discounts. Please supply proof of receipt of benefits when you enrol, e.g. copy of current Giro; payment book; letter from Jobcentre Plus; or a tax credit award certificate. Proof documents must be dated no older than 6 months and valid for the duration of your course. ...................................................................................................................... Signed ...................................................... Date ............................ Proof of co‐residence must be attached to this enrolment form. Signed ...................................................... Date ............................ 1112.e 146
2 of 2 To enrol on a course, complete the form on page 145
Refund of Course Fees
Disclaimers
Force Majeure
If a learner decides to withdraw from
a course before a course begins, the
following charges are applied:
Physical Activities
Surrey County Council and its partner
providers shall not be liable to the learners
enrolled on courses to the extent that it is
unable to perform its obligations by reason
of Force Majeure, provided that the Surrey
County Council and its partner providers
shall use all reasonable endeavours to
minimise the effect of the Force Majeure
and to resume performance of its
obligations as soon as practicable.
•
•
•
Up to 8 weeks before course starts, full
refund.
8 weeks to 1 week before the course
starts a £10.00 cancellation fee will be
charged regardless of course fee.
No refunds will normally be made if
a learner withdraws less than 7 days
before the start of the course.
Once a course has begun, Centre
Managers can only consider refund
requests in exceptional personal or family
circumstances. However, holidays, loss
of interest, new time commitments and
similar domestic changes do not qualify.
If a learner fails to attend a course for more
than four consecutive sessions, Surrey
County Council reserves the right to
withdraw the learner and offer the place to
someone on the waiting list.
Course Cancellation
The length of the course quoted is based
on a minimum number of learners enrolled
and financial viability of the course. If this is
not achieved it may be necessary to:
a) cancel the course before the first class,
and provide learners with a full refund;
or
b) meet for the first class when learners
will be given the opportunity to decide
whether to shorten the course hours for
the same fee, transfer to another course
or request a refund of fees.
In the event of severe weather, we will
provide information on any impact on
our classes by leaving a message on the
enrolment centre telephones. We will
also post notice of any disruptions on our
website.
All learners attending physical education
and associated classes (such as health,
fitness and dance) will be required to
complete a health questionnaire before the
start of a course.
Whilst the information given in this
questionnaire may aid the tutor in the
preparation and delivery of the courses,
neither they nor Surrey County Council or
its partner providers undertake to advise on
any medical condition, or whether any such
condition could be adversely affected as a
result of attending a class.
It is for learners to seek their doctor’s advice
either before or during the course if a
medical problem is indicated or if they are
new to physical exercise.
Insurance
Surrey County Council and its partner
providers cannot accept responsibility for
the loss of or damage to learners’ property.
Learners should ensure that they have
adequate “all risks” insurance cover for any
article belonging to them that they leave
on centre premises and car parks.
Errors
Whilst every effort is made to ensure
the accuracy of the information in this
directory, neither Surrey County Council
nor its partner providers accept liability for
clerical and typographical errors.
Surrey County Council and its partner
providers reserve the right to make
amendments as necessary provided that
these do not materially affect the course.
If, after application for a course has been
accepted, the course is substantially varied
from that described in this publication, the
learner is entitled to withdraw from the
course. In the event of such withdrawal, an
appropriate refund of course fees will be
made.
Surrey County Council and its partner
providers shall endeavour to provide
information for the learners enrolled on
courses as soon as reasonably practicable
after becoming aware of an event of
Force Majeure. The notice shall contain all
relevant information relating to the event
of Force Majeure including the nature and
effect of the Force Majeure, the actions
being taken (or to be taken) to minimise its
effect and an estimated duration.
Surrey County Council and its partner
providers shall take all steps necessary to
minimise the effect of the Force Majeure on
the provision of the courses.
Where Force Majeure has a material effect
on the provision of courses for longer than
four consecutive weeks, Surrey County
Council and its partner providers may
terminate the course being provided.
Important Information
Important Information
‘Force Majeure’ means war, civil war, armed
conflict, terrorist attack, governmental
action, fire, flood, severe weather
conditions, pandemic or epidemic or any
other act or matter which notwithstanding
the reasonable diligence and foresight
of Surrey County Council and its partner
providers is, beyond their reasonable
control.
How We Use Your Personal Information
The personal information you provide is passed to the Chief Executive of Skills Funding (“the Agency”) and, when needed, the Young People’s
Learning Agency for England (“the YPLA”) to meet legal duties under the Apprenticeships, Skills, Children and Learning Act 2009, and for the
Agency’s Learning Records Service (LRS) to create and maintain a unique learner number (ULN). The information you provide may be shared
with other partner organisations for purposes relating to education or training.
Further information about use of and access to your personal data, and details of partner organisations are available at:
http://skillsfundingagency.bis.gov.uk/privacy.htm
http://www.ypla.gov.uk/privacy.htm
http://www.learningrecordsservice.org.uk/documentlibrary/documents/Code+of+Practice+for+Sharing+of+Personal+Information.htm
147
Enrolment centres
Camberley Centre
Esher Green Centre
Farnham Centre
France Hill Drive,
CAMBERLEY GU15 3QB
19 Esher Green,
ESHER, KT10 8AA
25 West Street,
FARNHAM , GU9 7DR
Tel:
01932 794524
Fax: 01932 794542
Email:camberley.aec
@surreycc.gov.uk
Tel:
01372 832583
Fax: 01372 463696
Email:eshergreen.aec
@surreycc.gov.uk
Tel:
01483 518558
Fax: 01483 518555
Email:farnham.aec
@surreycc.gov.uk
Guildford Centre
Molesey Centre
Sunbury Centre
Sydenham Road, GUILDFORD
GU1 3RX
Henrietta Parker Centre,
Ray Road
WEST MOLESEY, KT8 2LG
The Avenue
Sunbury on Thames
TW16 5DZ
Tel:
01932 794554
Fax: 01932 794558
Email:molesey.aec
@surreycc.gov.uk
Tel:
01932 794514
Fax: 01932 794513
Email:sunbury.aec
@surreycc.gov.uk
Tel:
01483 518528
Fax: 01483 518535
Email:guildford.aec
@surreycc.gov.uk
Woking Centre
Highlands,
Bonsey Lane, Westfield
WOKING, GU22 9PR
Tel:
01483 518568
Fax: 01483 518564
Email:woking.aec
@surreycc.gov.uk
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Created by the Communication Design Team. 07.11.RN.CS2020.