ESFA #SkillsForLife Eligibility Questionnaire
Course Selection
Which training course are you interested in?
Please Select
Catering/Hospitality
Personal Training
Identity
Forename
Surname
DateOfBirth
Day
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2nd
3rd
4th
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Month
January
February
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July
August
September
October
November
December
Year
2034
2033
2032
2031
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2028
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2025
2024
2023
2022
2021
2020
2019
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2012
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1981
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1978
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1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
Your Education (Tick highest level you currently hold)
Please Select
Entry Level
Other Qualification Below Level 1 (GCSE D-G)
Level 1 (GCSE D-G)
Full Level 2 (5 or more GCSEs A-C)
Full Level 3 (2 or more A Levels)
Level 4
Level 5
Level 6
Level 7 and above
Other Qualification, Level not known
Not Known
None
Demographic
Gender
Please choose a value
F
M
Ethnicity
Please Select
White or White British
Preferred Not to Say
Asian or Asian British
Black or Black British
Any Other White Background
Any Other Black Background
Black British Caribbean
Black British African
Mixed White & Black Carribean
Mixed White & Black African
Kurdish
Other
Mixed White & Asian
Any Other Mixed Background
Any Other Asian Background
Turkish Cypriot
Turkish
Greek
Do you consider yourself to have a learning difficulty and/or disability and/or health problem?
Please Select
Yes
No
Prefer Not to Say
If yes, please tick all that apply. (Hold 'Ctrl' button for multiple selections)
Asperger's Syndrome
Autism Spectrum Disorder
Disability Affecting Mobility
Dyscalculia
Dyslexia
Hearing Impairment
Mental Health Difficulties
Moderate Learning Difficulty
Not Provided
Other Disability
Other Learning Difficulty
Other Medical Condition
Other Physical Disability
Other Specific Learning Difficulty
Profound Complex Disabilities
Severe Learning Difficulty
Social & Emotional Difficulties
Speech, Language & Communication Needs
Temporary Disability after Illness or Accident
Visual Impairment
Please indicate what you would consider your primary LLDD and health problem
Address
Address1
Address2
Town
County
Post Code
Contact
Telephone
Mobile
Email
Employment Status & Benefits
Please confirm your employment status
Please Select
In paid Employment
Not in paid employment, looking for work and available to start work
Not in paid employment, not looking for work and/or not available to start work
Date Employment Status Applies
Day
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
21st
22nd
23rd
24th
25th
26th
27th
28th
29th
30th
31st
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2034
2033
2032
2031
2030
2029
2028
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
If unemployed, how long have you been out of work?
Please Select
Less than 6 months
6 - 11 months
12-23 months
24-35 months
Over 36 months
Were you in full time education or training prior to enrolment?
Please Select
Yes
No
Are you currently claiming any benefits?
Please Select
Yes
No
If yes, which ones?
Your Housing Situation
Which of these options most accurately affects your current household situation?
Please Select
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 include any dependent children
Lives in a single adult household with dependent children
None of the above statements apply
I wish to withhold this information
Submit