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Isle of Wight Council iow logo
YOUTH AND COMMUNITY SERVICE
COURSE APPLICATION FORM
29 High Street
Newport
Isle of Wight
PO30 1SS
Tel: (01983) 823490
Fax: (01983) 520499
e-mail: [email protected]
Course Date
Course Title
Personal Details
Title
Forename
Middle name/Initials
Surname
Organisation/Project
Job Title
Building/house name/number
Street address
Town Name
County
Postcode
Work Number
(include area code)
Home/Mobile Tel Number
Email address
Special Needs, Dietary or Access Requirements (please identify)










Candidates signature..........................................................





Date.............................................................


Manager's signature......................................................



Date.............................................................
Office Use Only


Confirmation letter sent..................................



Reminder letter sent.......................................


Invoice sent..................................................
Data Protection Act 1998
padlock This application may be monitored by the Isle of Wight Council for regulatory, quality control or crime detection purposes. Information from this application will be processed in accordance with the Data Protection Act 1998 for the purpose of processing your particular enquiry/request. The Isle of Wight Council ("the Council") is the data controller. By completing this form you consent to the Council contacting you by email or nominated contact method in relation to your enquiry/request.

The information contained in this application may, in exceptional circumstances, be subject to disclosure to third parties under either the Data Protection Act 1998 or the Freedom of Information Act 2000 to the extent the law allows and in accordance with the Isle of Wight Council's Access to Information Policy . Disclosure will only be made where in all the circumstances it would be fair to do so and in the public interest.

Please note that the Council may process your information in the absence of consent for the purpose of crime prevention or detection so far as is in accordance with the law.

Sometimes we may use your information to keep you informed about services, goods or relevant issues that we believe may be of interest to you. If you wish to receive this information for these purposes please tick this box
To improve the quality of other services that we provide to you the Council wishes to hold your non-sensitive personal information on a secure central database. This will enable all Council services to use this information when they are providing a service to/for you. If you wish your non-sensitive personal information to be held by the Council please tick this box

Date printed: 07/03/2013