Anicca Skills Bootcamp Learner Application Form

Please ensure you read all the instructions & eligibility criteria before completing this form

1) Contact details

Title *

First Name *

Last Name *

Email *

Phone *

Confirm your phone number *

Other Email

Address *

Address Line 2

Postcode *

Town or City *

County *

Sex: *

Male

Female

Date of birth *

2) Eligibility Questions - this will determine if you are eligible for a free place (these questions are all compulsory)

Were you born on or before 31st August 2005? *

Yes

No - you are not eligible

Have you been a resident in the UK and/or EEA continuously for the last 3 years? *

Yes

No - You will need to complete an eligibility form during your screening call

Are you a UK national or a person with right of abode in the UK *

Yes

No - You will need to complete an eligibility form during your screening call

3) What course are you applying for?

The course starts on 23rd July 2025, please confirm your region below

About your employer (or your company if you are self-employed)

If the answer to A1 is Self Employed or Employer Supported please complete the following

Employer or Company Name *

What is your or your employer's company name? Unemployed - please write N/A. Student - please write that you are studying followed by the name of your University or College.

Employer - Address 1 *

1st line of the address of your company or employer, i.e. the local or regional office of where you work. If you work at home, enter the head-office or registered office. Unemployed or student please write N/A

Employer - Address 2 *

Employer - Town or City *

Town or city of your company or employer. Unemployed or student - please write N/A

Employer Postcode *

Select the county of the address of your company or employer. Employer - select the county

Select the county of the address of your company or employer.

Company Registration or UTR (Unique Tax Reference) Number *

Company URL

Your manager

Your Manager's Name *

If applicable, please provide your manager's name. This should be someone who can authorise your training and/or the funding of the course.

Your manager's email address *

Your Manager's Phone Number *

Section B - Not in Paid Employment

B1 - Not in Paid Employment

I am not in paid employment, looking for work and available to start work

I am not in paid employment, not looking for work and/or not available to start work

C - Benefit status

C1 - Which of the following benefit(s) do you receive? (tick all that apply)

Not in receipt of any benefits

Job Seekers Allowance (JSA)

Universal Credit

Employment & Support Allowance (ESA - all categories)

Other state benefits (please specify below):

National Insurance Number *

6) Other details

Can you commit to watch all the lessons live (1 day per week)?

Yes

You need to watch 1 full day each week on Thursdays for 14 weeks. You will be required to provide a record of what hours you live.

Impact of health conditions on your ability to work *

Do you have disabilities or long-term health conditions that impact your ability to work? (We will ask you details about this later)

Do you have a criminal conviction (excluding minor motoring offences)? *

Yes

Are you happy to provide the required evidence of career or business progression *

Yes

Do you agree to take the Skills test (with a score greater than 20%) after you have attended a 30 minute online screening interview? *

Yes

Do you have any caring responsibilities for children or other adults?Caring responsibilities for children or adults

Have you participated in a Skills Bootcamp since 31st March 2025? *

Will you be applying for a new job at the end of the course? *

How quickly do you want to take up a new job or placement opportunity in digital marketing?

Impact of any caring responsibilites on your ability to work *

Learner Declaration:

Please review the Learner Declaration below and confirm at the end of this document that you have read, understood and agreed to the declaration.

Information Advice and Guidance

I confirm that I have received information, advice and guidance concerning the Skills Bootcamp entitled [insert course title] delivered by [Training Provider Name]. This included information about the course, its entry requirements, the expected workload of the course, the number of guided learning hours and the support* available to me.

*For example, wraparound career and personal development support considering my employment history and existing skills; sector-specific Behavioural Skills Support for employment in sector [insert sector]; assistance with the drafting of my CV and preparation for interviews personalised to my individual learner needs. Such support may include but is not limited to:

giving interview preparation and guidance from industry professionals or Employers, with experience in the sector

Tailored career coaching from industry professionals with experience in [insert sector]

Purpose of Skills Bootcamp

I am clear what I will achieve by completing this Skills Bootcamp and agree to attend an interview with an employer (for a job using relevant skills gained from the Skills Bootcamp) arranged for me by [Training Provider Name] (unless I am self-employed, or learning with the support of my existing employer and they are contributing to the cost).

I confirm this Skills Bootcamp [insert title] is the only one I am currently enrolled on and this is the only one I have been enrolled on since 1st April 2025. I have been resident in the UK for three years prior to the first day of my Skills Bootcamp.

Handling of Personal Data

I agree to provide all data and information requested by Department for Education (DfE) to inform evaluation of the Skills Bootcamps programme and I confirm that the information I supply will be true and correct to the best of my knowledge. This data will include:

I agree to provide all data and information requested by the provider on behalf of the Department for Education (DfE) to inform evaluation of the Skills Bootcamps programme. This will include:

Sharing information about my income before the Skills Bootcamp and afterwards when I achieve a positive outcome. A positive outcome is defined as an offer of a new job or an apprenticeship for independent learners, a new role/enhanced role utilising the new skills acquired on the Skills Bootcamp for learners co-funded by an employer or, obtaining new opportunities/contracts for self-employed learners.

I agree that this information can be used to process my data for contractual requirements, in particular to the disclosure of all the data on this form or otherwise collected about me to the DfE for the purposes noted in the Privacy Notice. (attach the signed current DfE learner privacy notice in the contract and privacy Q&A).

Suffolk County Council is the 'Joint Data Controller' with the DfE for the 'Norfolk and Suffolk Skills Bootcamp Programme’ for related personal data and controls and processes personal data under the lawful bases of Article 6 (1) (e) and Article 9 (2) (g) of the European Union 'General Data Protection Regulation' (2016/679) as well as the Data Protection Act 2018. (attach the signed SCC Learner Privacy Notice from the contract)

Personal and related Employment data (if I am employed/self-employed) will be used to fulfil the contractual requirements of the DfE. Data and related claim processing evidence are uploaded to the DfE’s Individual Learner Record platform and Suffolk County Council’s SharePoint system, and accessed by named Suffolk County Council staff.

Skills Bootcamp Programme activity

I will:

Take appropriate responsibility for my own learning, development and progression

Attend and participate in the training required to successfully complete the Skills Bootcamp

Promptly inform [Training Provider] and employer if applicable, if any matters or issues arise, or might arise, that will, or may, affect my learning, development and progression

Respond to and engage with follow-up communications from [Training Provider] following completion of the training component of a Skills Bootcamp, and during the next six months, to record progression as a result of the course

Take responsibility to share evidence requested by [Training Provider Name], to allow [Training Provider Name] to prove the effectiveness of this Skills Bootcamp to DfE

I understand that [Training Provider] has the right to cancel my enrolment if it is found that I have provided false or inaccurate information.

Complaints Process

If you are not satisfied with any aspect of your Skills Bootcamp and wish to raise a complaint you should do so in the first instance with (Training Provider) by emailing (insert relevant contact name/role email) with full details of your issue. If you are not satisfied with how your complaint has been dealt with you may write to DfE through their Whistleblowing and Complaints process set out below.

Whistleblowing involves entering a 'whistleblowing' webform on the 'Contact the Department for Education' page, which can be found here: Contact the Department for Education - DFE Online Forms. Whistleblowing submissions for Skills Bootcamps must be clearly marked 'Skills Bootcamps'. They will be submitted via the DfE's whistleblowing submission process and will be escalated to the DfE Skills Bootcamps policy team for response.

I confirm that I have read, understand and agree to the learner declaration above and the learner privacy notices supplied:

Contact name

Learner Signature

Clear

Date form completed