QQI Level 6 - 6N1957 Special Needs Assisting - Blended

REGISTRATION - Application / Booking Form

Section 1: Your Details

First name*

Last name*

Email*

Phone number*

Please include your phone number using the following format, omitting the initial zero.
(E.g. +35389xxxxxxx)

Street address*

Street address 2

City/Town*

County

Eircode*

Do you hold a medical card or are you in receipt of social
welfare? *

Yes

Section 2: Course Details

Preferred Course Start Date*

Section 3: Equality and Diversity

Do you have any special requirements? (hearing / vision / mobility / very frequent breaks / literacy)

Yes

Do you have the necessary English language skills to complete this course?*

Yes

Do you have access to a computer/laptop with WiFi and the computer skills required to log into our LMS, send emails, use Zoom, and submit work through our website portal?*

Yes

Section 4: Invoice to:

Where did you hear about us?

Section 7: Terms and Conditions - Booking, Cancellation and Refund Policy

Please ensure to read our TERMS AND CONDITIONS here on our website before you submit your registration form. By checking the box below, you are agreeing to our terms of service.

I confirm that the information provided is accurate and complete and that I have read and agree to the terms and conditions.*