HGV Skills Bootcamp Application Form Please complete all fields within this form unless indicated as optional.First name *Last name *Mobile *Email Address *Date of birth *Address line 1 *Address line 2 (optional)Town *Postcode *Please select your region *Please select an option----EastEast MidlandsLondonNorth EastNorth WestSouth EastSouth WestWest MidlandsYorkshire and The HumberSex----FemaleMaleOtherPrefer not to sayEquality & Diversity Do you consider yourself to have a long term difficulty, health problem or learning difficulty?Difficulty/Disability----Has difficulty/disabilityNo difficulty/disabilityNo information providedIf yes, please tick belowPlease check those that apply to you04 - Vision impairment05 - Hearing impairment06 - Disability affecting mobility07 - Profound complex disabilities08 - Social and emotional difficulties09 - Mental health difficulty10 - Moderate learning difficulty11 - Severe learning difficulty12 - Dyslexia13 - Dyscalculia14 - Autism spectrum disorder15 - Asperger's syndrome16 - Temporary disability after illness (for example post-viral) or accident17 - Speech, Language and Communication Needs18 - Down Syndrome93 - Other physical disability94 - Other specific learning difficulty (e.g. Dyspraxia)95 - Other medical condition (for example epilepsy, asthma, diabetes)96 - Other learning difficulty97 - Other disability98 - Prefer not to say99 - Not providedDo you have any medicals conditions that may affect your application for a provisional licence?----NoYesIf so, please provide details. Enter N/A if you do not have any medical conditionsHousehold situation01 - No household member in employment, dependent children02 - No household member in employment, no dependent children03 - Learner lives in a single adult household with dependent children98 - Learner has withheld this information99 - None of HHS1,HHS2 or HHS3 appliesHGV Skills Programme Our Training Pathways range from: New HGV Cat C licence (Pathway A3), new Cat C+E licence for experienced drivers (Pathway B3), experienced Cat C driver upgrading to Cat C+E (Pathway D3), experienced HGV driver upgrading to ADR (Pathway E3) and previous HGV driver refresher (Pathways H3). We are currently dealing with an overwhelming number of applications, so the Pathway you select may be over-subscribed. In this case we will inform you via email and put you onto our waiting list.Please select which Training Pathway you are interested in.----Pathway A3 - Novice to Cat CPathway B3 - Novice to Cat C+EPathway D3 - Existing Cat C Upgrade to C+EPathway E3 - Existing HGV upgrade to ADR Packages and TankersPathway G3 - "Back to Wheels" Refresher into Previous Existing CategoryPathway H3 - "Back to Wheels" Refresher with Upgrade to Cat C+EAre you currently/recently been any of these?7.5 tonne driverBus or Coach driverCourier driverHome delivery driverNot applicableWhere did you hear about the HGV Skills Bootcamp scheme----Gov.uk WebsiteJobcentreLocal Training ProviderMantra LearningMy Current EmployerOtherRecruitment AgencySocial MediaVeterans into LogisticsEmployment Status Each field represents a specific category of information that we require:Employment status----10 - In Paid Employment11 - Not in paid employment, Looking for work and available to start work12 - Not in paid employment, not looking for work and/or not available to start98 - Not known/not providedDate status applies toEmployer IDEmployment intensity indicator----5 - Learner is employed for 0 to 10 hours per week6 - Learner is employed for 11 to 20 hours per week7 - Learner is employed for 21 to 30 hours per week8 - Learner is employed for 31+ hours per weekX1 - Learner is employed for 16 hours or more per weekX2 - Learner is employed for less than 16 hours per weekX3 - Learner is employed for 16 - 19 hours per weekX4 - Learner is employed for 20 hours or more per weekLength of unemployment----1 - Less than 6 months2 - 6-11 months3 - 12-23 months4 - 24-35 months5 - Over 36 monthsLength of employment----1 - up to 3 months2 - 4-6 months3 - 7-12 months4 - more than 12 monthsBenefit status indicator----Receives Job Seeker Allowance4 - Universal Credit5 - Learner is in receipt of Employment and Support Allowance (all categories)6 - Learner is in receipt of other sate benefitX - 2 - Receives Employment Support AllowanceX - 3 - Receives other state benefit other than JSA, Universal Credit or ESEPrevious education----1 - Full time education or trainingSmall employer----1 - Small employerAre you eligible to work in the UK----NoYesHave you lived in the UK for 3 years?----NoYesWhat is your employment status?----Unemployed and not seeking employmentUnemployed and seeking employmentFull time employed with a contract of employmentPart time employed with a contract of employment including zero hour contractSelf employedIf unemployed, are you currently claiming benefits? (optional)----NoYesBenefit Type----ESAJSAN/AUniversal CreditLength of Unemployment (optional)----0 - 6 mths12 - 23 mths24 - 35 mths36 mths +6 - 12 mthsIf employed, what is the name of your current employer? (optional)What is your current salary (please tell us your annual salary before tax i.e., 30000)GBPAre you applying for HGV Skills Bootcamp to progress with your current employer?----NoYesIf yes, has your employer agreed to provide a financial contribution to your training?----NoYesIf your employer has NOT agreed to provide a financial contribution OR you are currently unemployed, do you have/or already had an interview with a new employer?----NoYesName of new employer for your interviewDo you have a conditional job offer from this new employer?----NoYesIf you do not have an interview or conditional offer we can support via our employment linksPlease select how many miles you are willing to travel to commute to work----0 - 5 miles10 - 20 miles20 - 30 miles5 - 10 miles50+ milesPlease state the maximum duration you are willing to commute to work----0 - 30 mins30 - 60 mins60 - 90 mins90+ minsAre you happy for us to share your details with prospective employers?----NoYesI agree to apply for job opportunities for my selected Pathway with prospective employers during my Skills Bootcamp----NoYesI agree to attend any interviews offered to me by prospective employers during my Skills Bootcamp----NoYesIf you are progressing via your current employer we will contact them to arrange payment. Please provide the following details. Enter N/A if you are not progressing via your current employer:Name of employer contact responsible for paymentContact NumberEmail AddressDriving ExperienceDo you hold a Cat B licence (car)?----NoYesIf so, when was the licence issued?How often do you drive?DailyDo Not DriveMonthlyWeeklyPlease tick all licenses you holdFull Cat B (car)Full Cat CFull Cat C + EProvisional Cat CIf you hold a Cat C licence (Class 2 rigid HGV) when was it issued?----After September 2009Before September 2009Do you have any driving convictions?----NoYesIf yes, please provide details, please enter N/A if you have no convictionsDo you have any points on your driving licence?----NoYesHow many points? If you don't have any points on your licence please state 0Do you give consent for us to check your licence online?----NoYesDo you have any unspent convictions (driving or non-driving)----NoYesIf yes, please provide details, enter N/A if you have no unspent convictionsDigital Capability Part of the Skills Bootcamp programme involves online learning courses. If you need additional help with using digital technologies we can provide it.Do you have any of the devices listed below? Please select more than one if applicableAndroid TabletDesktop ComputeriPadLaptopSmartphoneWhat Happens Next? Thank you for providing this information. We will now review your application and subject to meeting eligibility requirements we will invite you to attend a virtual information session, during which we will outline the content of your programme.Privacy Notices The Skills Bootcamp programme is funded by the Department for Education and any personal information you provide may be shared with the Department for the purpose of evaluating the programme in accordance with the privacy notice which you can read by clicking below. By enrolling on a learning programme with Mantra Learning you agree to your personal data being shared with funding bodies, awarding organisations and other relevant organisations as set out in the Privacy Notice. https://thelogisticsacademy.co.uk/the-academy-policies/privacy-notice/I consent to Mantra Group contacting me for marketing purposes and to keep me informed of other opportunities and services that may be of interest. Mantra will not share your data with any third party except as set out in the Privacy Notice *YesI confirm that the information I have provided is true and accurate to the best of my knowledge. *YesPlease confirm that you have read and understood the Privacy Notices detailed above *YesSubmit Application