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Rutland Adult Learning and Skills Service COMMUNITY Learning Agreement FormCommunity Learning Agreement • September 9th, 2021
Title: Mr. Mrs. Ms. Miss Other Date of Birth: Male Female Other Forename(s): Surname/Family Name: Home Address: Phone Numbers: Email: Postcode: Postcode check: N-D D Would you like to join our course brochure mailing list?Yes No If you would like to nominate someone for us to contact in an emergency, please give their details below:Name: Relationship to you: Contact Number(s): Have you been living in the UK or EEA as a permanent resident for the past 3 years (or are a member of, or dependent of a member of, the British Armed Forces)?Yes No - Please specifyIf your answer is ‘no’, please contact us for more information.How did you hear about us?Our website Facebook Twitter Instagram Word of mouth Returning learner.Course brochure (printed.) Course brochure (emailed) Other – please specify. What is your nationality?
