Distance Learning Applying OnlineWelcome to the Distance Learning Online Application form, please fill in the required fields below.If your post code is located in one of the 7 devolved areas you may not be eligible for funding with the Grimsby Institute. You will be advised of this once we receive your application. Step 1 of 5 20% Name* Title Mr.Mrs.MissMs.Dr.Prof.Rev. First Last Date of Birth* Date Format: DD slash MM slash YYYY Email* Gender*FemaleMalePrefer not to sayOtherPermanent Home Address* Street Address Town/City Post Code Telephone Number*MobileChoice Of Course*Select a courseLevel 1 Award in Mental Health AwarenessLevel 3 Principles of End of Life CareLevel 3 Certificate in Understanding the Principles of Dementia CareLevel 2 Understanding Working with People with Mental Health NeedsLevel 2 Understanding Safeguarding and PreventLevel 2 Understanding Safe Handling of MedicationLevel 2 Understanding Nutrition and HealthLevel 2 Understanding Dignity and Safeguarding in Adult Health & Social CareLevel 2 Understanding Children and Young People’s Mental HealthLevel 2 Understanding Care and Management of DiabetesLevel 2 Understanding Autism in a Health Care SettingLevel 2 Principles of working with Individuals with Learning DisabilitiesLevel 2 Principles of Prevention and Control of Infection in Health Care SettingsLevel 2 Principles of Dementia CareLevel 2 Principles End of Life CareLevel 2 Preparing to work in Adult Social CareLevel 2 Introducing Caring for Children & Young PeopleLevel 2 Common Health ConditionsLevel 2 Certificate Understanding Behaviour that ChallengesLevel 2 Certificate in the Principles of Care PlanningLevel 3 Certificate in the Principles of Customer ServiceLevel 2 Understanding Retail OperationsLevel 2 Principles of Team LeadingLevel 2 Principles of Customer ServiceLevel 2 Principles of Business AdministrationLevel 2 Information, Advice or GuidanceLevel 2 Equality and DiversityLevel 2 Certificate in the Principles of Warehousing and StorageLevel 2 Certificate in Lean Organisation Management TechniquesLevel 2 Counselling SkillsLevel 2 Certificate in Falls Prevention AwarenessLevel 2 Certificate in Understanding Specific Learning DifficultiesLevel 2 Awareness of Mental Health ProblemsThis course is on offer as a fully on-line option.Please tick this box if you don't want to study this course online and we can send you workbooks in the post. I don't want to study this course fully on-line Save and Continue Later Are you Employed*NoYesIf yes please indicate the number of hours you work*0 - 1516 -3435+Are you currently looking and/or available for work?*YesNoAre you currently looking for further employment?*YesNoAre you in receipt of any benefits?*YesNoHave you lived in England or the European Union for all of the past 3 years?*YesNoCountry of Residence*EnglandPlease indicate your current status in the UK*Please note that if other than British we will need to see a copy of your passport or visa to help us determine your eligibility for funding for the course.British/EU citizenIndefinite leave to remainExceptional leave to remainDiscretionary leave to remainAsylum seeker/refugeeMarriage visaDependent visaWork permit/visaVisitor/touristMigrant workerOtherNationality*BritishEnglishWelshScottishIrishNorthern IrishAfghanAlbanianAlgerianAmericanAndorranAngolanAntiguansArgentineanArmenianAustralianAustrianAzerbaijaniBahamianBahrainiBangladeshiBarbadianBarbudansBatswanaBelarusianBelgianBelizeanBenineseBhutaneseBolivianBosnianBrazilianBruneianBulgarianBurkinabeBurmeseBurundianCambodianCameroonianCanadianCape VerdeanCentral AfricanChadianChileanChineseColombianComoranCongoleseCongoleseCosta RicanCroatianCubanCypriotCzechDanishDjiboutiDominicanDominicanDutchDutchmanDutchwomanEast TimoreseEcuadoreanEgyptianEmirianEquatorial GuineanEritreanEstonianEthiopianFijianFilipinoFinnishFrenchGaboneseGambianGeorgianGermanGhanaianGreekGrenadianGuatemalanGuinea-BissauanGuineanGuyaneseHaitianHerzegovinianHonduranHungarianI-KiribatiIcelanderIndianIndonesianIranianIraqiIsraeliItalianIvorianJamaicanJapaneseJordanianKazakhstaniKenyanKittian and NevisianKuwaitiKyrgyzLaotianLatvianLebaneseLiberianLibyanLiechtensteinerLithuanianLuxembourgerMacedonianMalagasyMalawianMalaysianMaldivanMalianMalteseMarshalleseMauritanianMauritianMexicanMicronesianMoldovanMonacanMongolianMoroccanMosothoMotswanaMozambicanNamibianNauruanNepaleseNetherlanderNew ZealanderNi-VanuatuNicaraguanNigerianNigerienNorth KoreanNorwegianOmaniPakistaniPalauanPanamanianPapua New GuineanParaguayanPeruvianPolishPortugueseQatariRomanianRussianRwandanSaint LucianSalvadoranSamoanSan MarineseSao TomeanSaudiScottishSenegaleseSerbianSeychelloisSierra LeoneanSingaporeanSlovakianSlovenianSolomon IslanderSomaliSouth AfricanSouth KoreanSpanishSri LankanSudaneseSurinamerSwaziSwedishSwissSyrianTaiwaneseTajikTanzanianThaiTogoleseTonganTrinidadian or TobagonianTunisianTurkishTuvaluanUgandanUkrainianUruguayanUzbekistaniVenezuelanVietnameseYemeniteZambianZimbabwean Save and Continue Later Are you currently undertaking any other qualification?*YesNoIf Yes which qualification?*What is your highest level of English/literacy?*No qualificationA LevelCSE Grade 1CSE Grade 2Functional Skills Level 1 or 2Degree or higherGCSE Grade C or higherGCSE Grade DGCE Grade DLevel 2 or higher NVQ/DiplomaOther QualificationOther Qualification*If you are not sure about your highest level of English/literacy please undertake the on line literacy assessment, click here for the online assessment. This will take no longer than 20 minutes to complete. Instructions are available hereI confirm that I have read the information about the course for which I am applying and specifically how the course is assessed. I am aware of the need to access company policies and procedures where applicable (Safe Handling of Medication and Working with People with Mental health Needs) and any other requirements as detailed in the How Assessed section of this website. I am aware of the time commitment and assessment requirements and can commit to these requirements. I am aware of the £85 non-completion fee for which I am liable if I have to be withdrawn from the course.I am aware of the time commitment and assessment requirements and can commit to the above requirements.* Yes Save and Continue Later Why do you want to take the course/training for which you have applied ? Save and Continue Later Terms & Conditions*I agree to the Terms & Conditions and understand that distance-learning-courses.co.uk has a legitimate interest to process the data that I have submitted. See our Terms and Conditions for more information. Yes NameThis field is for validation purposes and should be left unchanged. Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.