ELCAS Course Booking Form

SECTION 1 - Course Details

Course Title:
Venue:
Date:

SECTION 2 - Learner Details

Your Name:
Your Home Address (inc full postcode):
Your Work Address (inc full postcode) - if applicable:
Your Contact Phone Number (mobile and/or landline):
Your Email:
EOP (Equal Opportunities Policy)
If there is anything that may affect your learning that you feel we should be aware of, please provide details below:

If you have a medical condition that we should be aware of i.e. epilepsy, diabetes etc.. please provide details below:

Date of birth:

Please confirm your gender identity i.e. Male, Female.

SECTION 3 - Payment Details

Once your application to use ELCAS funding has been authorised, you will be required to send us a copy of your Claim Authorisation Note (CAN) Form. Once we have received your CAN Form, we will generate an invoice for your 20% contribution towards the total cost of your training. One the invoice has been paid, your place on the course will be secured. If you have any queries regarding the ELCAS process, please do not hesitate to get in touch.

SECTION 4 - AGREEMENT & SUBMISSION

"I agree to abide by the Terms & Conditions of the course booking process laid out by Gryphon Safety & Security. I accept and understand that a course place will not be considered 'booked' or a place reserved on the system for me until full payment has been received. By ticking the 'I CONFIRM' box below I am confirming that I have read, understood, and accept in full, the Terms & Conditions of booking."

"I CONFIRM"

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