ETC course request form 2018 100% of survey complete. Question Title * 1. Course organiser name Question Title * 2. Contact email address Question Title * 3. Contact phone number Question Title * 4. Address for invoicing (if applicable) Question Title * 5. Do you believe any of your participants qualify for the fee waiver? Yes No Question Title * 6. If yes, please specify below (tick all that apply)Young people aged 10 to 24 years old who are disadvantaged by: Living in areas of deprivation (0-20% most deprived on SIMD) Being unemployed, not in education or training Being excluded, or at risk of exclusion from school Being at risk of being involved in antisocial behaviour, offending/reoffending Living in care Question Title * 7. Are you interested in the SCQF accredited version of this course? Yes No Question Title * 8. Which module would you like to request the delivery of? Module 1- Working with Young People in Sport (4 hours, or 6 hours SCQF accredited) Module 2- The Human Connection (2-3 hours, or 4 hours SCQF accredited) Module 3- Benefits of Sport and Physical activity (2-3 hours, or 4 hours SCQF accredited) Module 4- Communication (2-3 hours, or 4 hours SCQF accredited) Module 5- Dynamic Youth Award in a Sports Setting (2-3 hours, or 4 hours SCQF accredited) Module 6- Goal Setting (2-3 hours, or 4 hours SCQF accredited) Module 7- Conflict Resolution (2-3 hours, or 4 hours SCQF accredited) Module 8- Standard Life- Step Up in Life (2-3 hours, or 4 hours SCQF accredited) Question Title * 9. On what date(s) would you like this module to be delivered?Please note that all requests must be submitted a minimum of 4 weeks prior to first delivery date. Date Date Second date if split delivery Date Question Title * 10. What start and end time(s) would you like for this module delivery? Start time (delivery 1) Time AM/PM - AM PM End time (delivery 1) Time AM/PM - AM PM Start time (delivery 2) Time AM/PM - AM PM End time (delivery 2) Time AM/PM - AM PM Question Title * 11. Do you have a venue for this course? Yes Provisional No If yes or provisional please provide address and details below. Question Title * 12. How many people do you expect to have attending this course? Question Title * 13. Please provide some background to the group who will attend the training. Question Title * 14. Are you happy for this course to be open to other participants outwith your group? Yes No Question Title * 15. Any other notes, questions or requests on the training. Done