Qualification Registration Form Title*Please SelectMrMrsMissMsGender* Male Female First name* Middle Name/s Last name* Nationality Date of Birth* DD slash MM slash YYYY Student full home address*Student Email Address* Student Telephone Number (Mobile)*Student Telephone Number (Home)Emergency ContactTitle*Please SelectMrMrsMissMsFull Name* Relationship to Student* Telephone Number (Home)Telephone Number (Mobile)*Address*Training Centre DetailsName of the training centre you are attending* Special RequirementsTO TICK ANY OF THE BOXES IN THE SPECIAL REQUIREMENTS SECTION YOU MUST HAVE WRITTEN EVIDENCE FROM THE APPROPRIATE MEDICAL SECTOR. PLEASE EITHER EMAIL OR POST COPIES TO SUMMIT GROOMER TRAINING GROUP.Do you have any particular assessment requirements? Please tick as appropriate:* No Visual Impairment Physical Impairment Sensory Impairment Language Barrier Other Do you have any particular assessment requirements? - Other If you have special requirements please identify which aids would assist during your assessment: Extra time for your assessment Reader Font Size Text Type Page Colour Physical, technical or mechanical aids Please briefly provide any extra detail, if necessaryTraining & QualificationWhich qualification are you registering for?* City & Guilds 7863-02 - Level 2 Dog Grooming Assistant City & Guilds 7863-03 - Level 3 Diploma in Dog Grooming City & Guilds 0146-21 Dog Walking City & Guilds 0146-20 Pet Sitting VSPCDC018 Vetskill Vtec Level 3 Award in Preventative Canine Dental Care and Oral Hygiene If you have selected 7863 - Level 3 Diploma in Dog Grooming, have you successfully completed the Level 2 Dog Grooming Assistant* No Yes I didn't select 7863 Level 3 Diploma in Dog Grooming If you selected 7863 - Level 3 Diploma in Dog Grooming, what is your City & Guilds registration number? If you didn't select 7863 enter N/A* If you have selected VSPCDC018 Vetskill Vtec Level 3 Award in Preventative Canine Dental Care and Oral Hygiene N/A I have a regulated level 2 animal-related qualification and evidence that I am actively working within the animal care industry. I have a minimum of twelve (12) months experience of working within the animal care industry and evidence that I am actively working within the animal care industry If you have selected VSPCDC018 write a brief statement of relevant industry experience and current occupation. Please forward a copy of relevant certification to email@example.com Expected course start date DD slash MM slash YYYY Expected completion date DD slash MM slash YYYY Terms & ConditionsThe school you have registered with should have provided you with a contract outlining your training; what you can expect from the course; how it is delivered; over what time period and how you will be assessed. At the beginning of the course, you will be provided with an induction and an Individual Learning Plan which outlines your training, documented reviews and feedback regarding your progress, assessments and assignments. You can expect to be given a student information pack including all the assessments and assignments you will need to complete during your training. You will be expected to have completed your assignments by the end of your course. You will receive a certificate once you have fully completed and passed all given tasks within the qualification. Please note: a salon certificate is NOT an awarding body certificate. Summit Groomer Training Group operates a dispute resolution procedure in line with the awarding body's requirements. Should you need to refer to this, please ask your school for a copy, or contact Summit for further details. I understand that this application is for admission only for the qualification/s indicated. I agree to the release of any transcripts and results. I certify that this information is complete and accurate. I understand that making false or fraudulent statements within this application will result in disciplinary action. I understand that my chosen school will pay Summit Groomer Training Group the registration, exam and certification fees and that this is a non-refundable fee.Do you understand and agree to the terms stated above?* Yes Date terms accepted* DD slash MM slash YYYY SignatureCAPTCHAPhoneThis field is for validation purposes and should be left unchanged.