Learner Registration Form

Please ensure this form is filled out correctly, especially the spelling of your name as it will appear like this on your certificate.

If there are any mistakes, please let us know as soon as possible.

Learner Registration Form

How would you describe your ethnic origin?

White Asian or Asian British Black or Black British Mixed ethnicity Other ethnic group

English Welsh Scottish Irish Northern Irish Gypsy or traveller Other white background

Indian Pakistani Bangladeshi Chinese Other Asian background

Caribbean African Other Black background

White and black Caribbean White and Black African White and Asian Other mixed

Proof of identification

Drop files here or Click to select file.

Upload a Copy of Your Environmental Permit

Drop files here or Click to select a file.
*This is to ensure you are registering for the correct award.

CIWM (WAMITAB) Award to be enrolled onto *if you are unsure, please leave blank

Full Address of where the training will take place For level 4’s, please ensure this is the address of the permitted waste site

Have you been registered with WAMITAB/CIWM in the past? If Yes, Please provide your registration/learner number

Two years after achievement of your CIWM WAMITAB award you will be required to complete a continuing competence test if you wish to act as the TCM for your waste site. Would you like a reminder for when this is due? Please enter yes or no

Data Collection and Use: The information provided on this enrolment form is stored both electronically and paper based. We also share information for registration purposes with the Awarding Body and/or Regulatory bodies for an enrolment number to be generated. Please refer to our Privacy Policy for full details on how we store and use data.

EQUAL OPPORTUNITIES MONITORING PLAN

All assessment Centres/training providers are required to operate an Equal Opportunities Policy. Enviroawards are committed to making its Equal Opportunities Policy fully effective. All Learners are therefore asked to provide the following information, which will be treated in the strictest of confidence and used only for statistical monitoring purposes and for making reasonable adjustments to learning.

Do you have any disabilities and/or registered disabled?

Yes No

If yes, please provide details of your disability

I have read and understood the notes overleaf and the centre may disclose to the employer information held in connection with my assessment for the CIWM (WAMITAB) award. I have provided accurate information on the Equal Opportunities Questionnaire and I confirm I have read and accept the CIWM (WAMITAB) learner fair processing notice.

I wish to be registered and assessed for the CIWM (WAMITAB) qualification(s) as set out above.

I have read and understood the notes above

01582 363 282

info@enviroawardsltd.co.uk

01582 363 282

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Learner Registration Form

Learner Registration Form

EQUAL OPPORTUNITIES MONITORING PLAN

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