Personal Details

Embark Learning

Pre-Employment, Health & Social Care Training Enquiry Form

To be considered for the above programme, please complete the form below. If you are a job coach – please complete on behalf of your client.

Our privacy policy is available at https://www.embarklearning.co.uk/privacy-policy

Thank you for your interest in our premium Health & Social Care employment programmes.

To be considered, please complete all sections below and take your time to make sure this is the right programme for you and your answers are accurate. If you are a job coach completing this on behalf of your client, please ensure that your answers are correct before submitting. Mandatory boxes are marked with an Asterisk *

We’re looking for individuals who are genuinely interested in not just starting a course, but a meaningful and rewarding career in Health & Social Care. Please make sure you are enquiring for the right reasons. A video from people involved can be found below:

https://www.youtube.com/watch?v=ZYpJJ7mSGRE

Enquiry Details:

Section 1 - Eligibility

Were you aged 19 or over on 31st August 2025?*

Yes

Are you a United Kingdom (UK) / Irish Citizen or do you have the right to live in the UK with no immigration restrictions?*

Yes

Have you been living permanently in the UK / Ireland for at least the last 3 years? - QUESTION TO BE REMOVED

Yes

If you answered No to any of the above questions, please call us on
0330 024 1370 and select Option 2 before completing this form.

Your Personal Details:

Section 2 - Your Personal Details

Please ensure all details are correct as these will be used to contact you and potentially for any certificates in future.

First Name(s)*

Surname*

Date of Birth (please use the format dd/mm/yyyy)*

Mobile Number*

Email*

Postcode*

Address 1*

Address 2

Town

County - REMOVED FROM FORM

Section 3 - Preferences and Referral

Your preferred venue may not always be available, and you may be invited to the next available closest location – this may be due to funding available in your area.

Preferred Venue*

Name of referring organisation:*

Name of Job Centre:

Name of Job Coach / Embark Advisor making the referral (if applicable):

Section 4 - Qualifications

Do you already have a health and social care qualification?*

Yes

If Yes, please provide the full qualification title, level and year achieved below;

Section 5 - Your Values and Suitability

These roles require a strong level of English communication. Are you able to communicate effectively with people, both verbally and digitally?

Health & Social Care can sometimes be a physically demanding role, and you may be asked to be on your feet for long periods or take part in some strenuous movement. Will this be OK? *

Yes

Personal Care is a key part of all of our roles. We as social carers cannot choose to care for male or female clients. We will provide full training for this. But please confirm if you are comfortable with tasks such as helping someone wash, dress, eat and help with going to the toilet if they need support? *

Yes

Not Sure

Are you flexible with your working times and happy to travel up to an hour to get to work? Shift patterns are as follows: Early 7am – 2pm or Lates 2pm – 9pm or Full Days 8am-8pm or Nights 8pm-7am *

Yes

We will require every applicant to complete a DBS (Disclosure & Barring Service) Check (this will be paid for on successful completion). Please highlight any convictions below (this information will remain confidential):

Section 6 - Support Needs

Do you have any disabilities, learning needs, or other support requirements you would like us to be aware of? (This information will remain confidential):

Our privacy policy: https://www.embarklearning.co.uk/privacy-policy

Your IP adress is:

Please click the SUBMIT button below.