Application Form

 

Course Application Form  

Applicant Details

Name    Contact Telephone No.  
Address   Postcode   Unison Membership No.  
Branch  
E-Mail Address:   Position Held  
   

 

                                                      Course Details

 Course Title:  
Venue/Location  
Course Dates:  
   
 Please tick your ethnicity below: 

  • Black African
  • BlackCaribbean
  • Black Other
  • Bangladeshi
  • Chinese
  • Indian
  • Pakistani
  • Irish
  • White
  • Other (please state)

 

 

No member should be deterred from applying for a course because of individual needs. Please give details of your access and other needs here – use a separate sheet if you need to -

Branch Authorisation

 I have informed my branch that I have applied for the course and I am starting to make arrangements for time off to attend Signature of applicant…………………………………………………. Date…………………………. 
 The above named has branch approval to attend Signature from Branch………………………………………………….Date………………………….. 
         

 

Please note: All applications must be signed by your branch. Unauthorised forms will not be processed.

www.unisonnw.org.uk/unisoncourses

The UNISON Regional Centre, Arena Point, 1 Hunts Bank, Manchester, M3 1UN

Fax: 0161 661 6710 Tel: 0161 661 6777 

email k.scott@unison.co.uk

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