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Expression of Interest - Your details

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  • Email
  • Home Phone
  • Mobile
  • Text/SMS
  • Post

Emergency Contact Information

Your chosen course(s) / workshop(s)

Background Information

This information is for monitoring purposes only and will be kept confidential. Please tick all that apply.

  • currently
  • previously
  • currently
  • previously
  • A SWYPFT member of staff
  • A staff member from another service
  • Other (please specify)
  • Prefer not to say

Individual and learning needs

The Recovery College is committed to supporting all of our learners. Please tell us you have any specific support or learning requirements that you think we should be aware of and how we can help with these. These may include, but are not limited to, large print course materials, level building access, extra breaks, one to one support to help to work towards your learning plan?

  • Physical disabilities
  • Mental health diagnosis
  • Learning disabilities
  • Dyslexia
  • Autistic spectrum disorder (including Asperger's syndrome)
  • Allergies (please give details)
  • Other (please give details)
  • None

Equality and Diversity Monitoring

  • English
  • Other (including sign languages) please specify
  • I do not have a disability
  • Long standing illness
  • Mental health condition
  • Learning disability
  • Physical impairment
  • Cognitive impairment (e.g. Dementia, Autism, ADHD)
  • Speech impairment
  • Other (please specify)
  • I prefer not to say
  • Female
  • Male
  • Live in a gender other than assigned at birth
  • I prefer not to say
Yes No Prefer not to say
Yes No Prefer not to say
  • Single
  • Married
  • Widowed
  • Divorced
  • Separated
  • Co-habiting
  • In same sex civil partnership
  • I prefer not to say

Recovery College Charter

The Recovery College aims to create an environment that encourages learning and where students feel they are supported. This charter is designed to help students to understand what is expected from you and of us, whilst accessing the college.

What you can expect from us:

We will respect you as an individual at all times. We will do this by:

  • Respecting your values, opinions and beliefs
  • Equality of opportunity, free of harassment and discrimination
  • Helping people that support you to access courses e.g. a career, friend or interpreter
  • Behaving in a way that fosters a shared understanding and mutual respect
  • Encouragement to take responsibility for your own learning and development
  • Opportunities for you to comment on and review the courses and facilities on offer
  • Clear information about the courses on offer
  • The chance to celebrate success
  • Suitably trained facilitators and volunteers who are committed to the quality of your experience and to their own professional development

What we expect from you:

  • Respect the rights, choices, beliefs and opinions of others
  • Commit to attending course/workshop you have enrolled on
  • Do my best to inform the college ahead of time, if I am going to be late or miss a session and return from my breaks in a timely manner
  • Respect the college environment and equipment
  • Ensure mobile phones are on silent/turned off before entering any learning area
  • If I act in a way that may put myself or others at risk, I understand I may be asked to leave the course
  • Avoid the use of language or terminology that might offend others
  • Do not attend the college if under the influence of alcohol or substances, because if affects my ability to learn and/or ability to conduct myself respectfully.
  • I agree to behave appropriately within the learning environment and accept guidance from the course facilitator
  • Keep us informed of any special needs or requirements you have so we can support you in the best way possible
  • Seek early advice and support whenever you need clarification, or if you have a problem
  • I will keep any personal/private information heard during any course strictly confidential

By filling out this form and enrolling on these courses, I am confirming that I will attend these courses and abide by the College's code of conduct. I understand that failure to attend these courses without contacting the Recovery College beforehand may result in a period of time where I am unable to attend any courses that I have enrolled on or was planning to enrol on. I also understand that if I am in danger, or there is a risk to myself or others, the information that I have given may be shared with others to ensure everyone's health and safety. We shall let you know if we have to share this information.




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