Solas Learner Detail Form

Thank you for applying for a further education and training course. Everyone who registers for a course must complete all sections that apply to them in this form.

We ask a lot of questions in this form so it may take you some time to complete it. The information you provide helps us to improve our service to you and also to improve education and training in Ireland. All personal information is kept safe and confidential in line with current data protection regulations.

What you need to complete this form

The title and PLSS reference number of the course you are applying for – your course provider can give this to you.
Your Personal Public Service Number (PPSN).
Your medical card number if you have one.
Specific information if you are from outside the European Economic Area (EEA).

Next steps

Fill-in sections 1-4 of the form. Section 5 is optional, but you must tick if you do not want to answer the questions. Ask your course provider if you have any questions or if you need help filling in the form. If you do not complete Sections 1, 2, 3 and 4, we cannot register you for a course.
Sign the Data Protection Statement (page 10), We need your signature to confirm that you have read and understood how we will use and share the personal information you provide in this form.
Return your completed and signed form to your course provider.

Data Protection By completing and signing this form you agree that we and other organisations may use your personal information in Sections 1, 2, 3 and 4 of this form for example to manage your application, contact you about your application, gather information and statistics about courses and to comply with monitoring and reporting requirements. If you decide to provide information in Section 5, you agree to let us and other organisations use your sensitive personal information. Please read and understand the Data Protection Statement carefully before signing on page 10. We need your signature to confirm that you have read and understood how we will use and share the personal information you provide in this form.

Course Details:

The course you are interested in? If you don’t know these, ask your course provider

Course Title

PLSS Reference

Your Personal Details

Please fill in your information below

Name*

PPSN:*

Address

Town

County

Eircode

Phone (Mobile)*

Phone (Landline)

Email Address

Gender*

Date of Birth*

Nationality

Country of birth

Emergency Contact Details

Please fill in details of 2 people close to you

Emergency Contact Name 1

Phone

Emergency Contact Name 2

Phone

Are you under 18?*

Name of your parent / guardian

Phone of your parent / guardian

Email of your parent / guardian

Social Welfare Details

Social Welfare Payments, including Benefits and State Payments before starting the course

Do you have a Medical Card?*

Medical Card Number

Expiry Date

Which of the following applies to you before starting the course

Who are you dependant of a Social Welfare/Training Payment with?

How many weeks have you received welfare payments or signed for credits:

In Receipt of a Welfare Payment?

Complete this section if you receive a Welfare Payment

What payment(s) do you receive?

Hold down CTRL to select multiple listings

Do you receive any other welfare payment?

If Yes, please state what it is:

Outside European Economic Area (EEA)?

This section is only for those who are from outside the European Economic Area (EEA) Can we talk about this one? Basically you are already asking the question about nationality / country of birth, so this question can be tied in with that? Basically if I say I am from Japan then this section will load up. Whereas if I say I am from any country within the EU then this is not relevant? Hence use conditional logic here?

Your highest level of education and training (before starting this course) – and supports sought

Please tell us what is the highest level of education you have had and the country where it took place, before starting this course. Tick one box below and write in the information we ask for (Year, Course Title, and Country where you studied, if not Ireland).

Select what applies to you

Year

Course Title (if applicable):

Country (if outside Ireland):

Have you gained qualifications or credits through the formal Recognition of Prior Learning (RPL) process (tick one box):

Have you taken part in non-formal learning in the last 4 weeks

Non-formal learning includes things like private lessons, organised sessions for on-the-job training, workshops or seminars.

Do you need learning support?

Tick all of the boxes that apply. Your Course Provider will make every reasonable effort to put supports in place for you but they might not be able to put all of the supports in place for practical and other reasons.

I need support with:

Need other Support? List it here.

Your economic status (before starting this course)

What is your main economic status before starting this course (Tick one box only):

When did this economic status begin:

If less than a year

If a year or more: give number of years

Section 4.1: Your last or current employment (job)

If you were employed before or are currently employed, please fill in this section. If you have never been employed, ignore this section and go to section 5 We can make this part conditional as well for certain users - bear this in mind.

What is your last or present job title:

How long have you been in your last or present job:

Was this job Full Time or Part Time?

Employment status in last job you had or in your present job

What type of contract did you or have you got

Section 5: Your further details

If you provide information in this section, it will only be used for statistical purposes. This section only needs to be filled in when you are on the course.