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CSCS Referral form
Registration For Course
This form is to refer yourself (or your candidate ) to CSCS course with Action West. Please remember that this process can take up to 5 days.
*
1.
Contact details
(Required.)
Full name
Address
Borough
Postcode
Email
Phone number
Date of Birth
*
2.
National Insurance Number
(Required.)
*
3.
Which race/ethnicity best describes you? (Please choose only one.)
(Required.)
White/White British
Black/Black British
Asian/Asian British
Mixed race
Rather not say
Another race or ethnicity (please specify)
*
4.
Are you on probation?
(Required.)
Yes
No
5.
Please confirm the advisor and contact details of your advisor?
Advisor name
Advisor email
*
6.
Which of the following valid form of right-to-work do you currently have?
(Required.)
Passport
Driving License
Birth certificate
Biometric Residency Card
Letter from job center/Universal Credit statement
Bank statement
Other (please specify)
*
7.
How would you like to be contacted?
(Required.)
Text
Called
Whats app
All
