Expression of Interest Capture Form

Enrolment Form - Your details

First NameThis is the name that will be shown on certificates

Surname/family name

Date of Birth

/ /

Address

Town/City

Postcode

Landline telephone number

Mobile Phone Number

Email Address

Validate Email Address

Method of contact We will contact you via email except in an emergency. If you do not have access to email, what is your preferred method of contact?

Home phone
Mobile phone
Text/SMS
Post

How did you hear about us?

If 'other', please specify (hear about us)

Emergency Contact Details We need to have an emergency contact number in order to process your registration form. This cannot be a GP.

Full name of someone who can act as your emergency contact

Their contact number

Relationship of the emergency contact to yourself

About You

Which category best fits your situation?

in the past 2 years have you been

Staff / Placement student options

Employment Status

Which is your preferred type of course?

face-to-face
online
no preference

Supporting you and your requirements

Is there anything else you would like to tell us that would enable us to support you with your learning?

Equality and Diversity Monitoring This information is anonymous and will only be used to monitor who we are engaging with. This will help understand whether we are reflective of the diversity of our population

If you prefer not to answer these questions please tick here

Age Group

What is your gender identity?

Other (gender identity)

Do you consider yourself to be transgender?

Yes No Prefer not to say

What is your sexual orientation?

If 'other' please specify (sexual orientation)

What is your ethnicity?

Other (Ethnic origin)

Are you an asylum seeker or refugee?

Yes No Prefer not to say

What category below best describes your religion or belief?

Other Religion or Belief

Please check this box if you have served in the UK Armed Forces.

Please specify 'other' disability

Privacy Notice

This privacy notice is issued by Mind Recovery Net and can be read via the link: https://mindrecoverynet.org.uk/privacy/

Recovery College only. The information that you provide will be used in the following ways:

When booking onto courses - to send you booking information and pre-course information.
Marketing materials including - prospectus and timetable updates, upcoming courses and Student Voice information.
Your information is held on a secure database and is never shared with third parties. For any further information around the protection of your data please read https://mindrecoverynet.org.uk/privacy/
We will ask you for basic demographic information including your name, contact details and emergency contact information.
You can also choose to share further information about any disabilities related to your learning needs.
The enrolment does not include an assessment of your mental health. This is something that health care professionals can help you with, if it is relevant to your time as a student with us.
Enrolment at the college is voluntary and you can end your enrolment with us at any time.

For further information about Data Protection please see the Hampshire and Isle of Wight NHS Foundation trust, found here https://hiowhealthcare.nhs.uk/privacy-notice We use MRN to help us administer your data at the Recovery College (see privacy policy above)

Learner Declaration

I confirm that I am over the age of 18

I agree to observe all Recovery College regulations, this can be found on page 20 of the Prospectus: https://hiowhealthcare.nhs.uk/application/files/2517/2961/0044/Digital_Prospectus_2024-25_Low_Res.pdf

I understand that the Recovery College will store the information on this form and other information while attending the Recovery College subject to the provisions of the Privacy Notices mentioned above and the Data Protection Act 2018.

By submitting this form, I have read and understood the Privacy notices outlined by Mind Recovery Net, Recovery College and Hampshire and Isle of Wight NHS Foundation Trust, I have read and understood the Student Charter as outlined in the Recovery College Prospectus page 20. I agree to all and confirm that the information given on this form is true, complete and accurate. I accept that if this is not the case, the Recovery College shall have the right to cancel my application.