The Lightning Protection Academy
Qualified Students
1
CITB LOGO
National Specialist Accredited Centre

NVQ Learner Registration Form

Note: The name given above will be written exactly the same on the learner's certificate so please ensure that the spelling is correct.
Note: The address given above will be the address where the learner’s certificate is sent to so please ensure that it is correct.
The CITB (Construction Industry Training Board, registered charity number 264289) will use your personal data. Your personal data is information which identifies and relates to you including your contact details and photographic image and includes information we obtain directly from you or from third parties, or as a result of our relationship with you in our capacity as a Sector Skills Council and Industrial Training Board and in providing goods and services to you. We may use your personal data for the purposes connected with our role as a Sector Skills Council and Industrial Training Board and in providing goods and services to you. We may disclose your personal data to third parties, and organisations who provide services to us, for the purposes outlined above, but we will not otherwise pass your personal data to third parties for marketing purposes.

Skills Funding Agency

The information you supply will be used by the Skills Funding Agency, an executive agency of the Department for Education (DfE), to issue you with a Unique Learner Number (ULN), and to create your Personal Learning Record. For more information about how your information is processed and shared refer to the Extended Privacy Notice available on Gov.UK.

NOTE: On submission of this form you will be registered with NSAC the National Specialist Accredited Centre

Learner Declaration
[field id="fname"]
[field id="sname"]
[field id="home_address"]
[field id="pcode"]
[field id="email"]
[field id="dob"]
[field id="mobile"]
[field id="award_desc"]
[field id="award_code"]
[field id="employer_name"]
[field id="ethnicity_code1"]
[field id="ethnicity_code2"]
[field id="ethnicity_code3"]
[field id="ethnicity_code4"]
[field id="ethnicity_code5"]
[field id="disability_code"]
[field id="gender"]
[field id="citb_reg"]
[field id="end_date"]
[field id="iqa_name"]
[field id="assessor_name"]
[field id="learner_sign_date"]
signature
[field id="learner_sign_date"]
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