Joint Learning Programme - Registration - Step 2

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Personal Details  
Gender: Male  Female
First Name:
Last Name:
Email:
Please Note: You must use your work email address
Assignment No:   This can be found on your payslip
Work Info  
Job Title:
DPT Department:
Work Location Line 1:   (i.e RD&E Wonford)
Work Location Line 1:   (i.e Exeter)
Your Managers Info  
Your Manager:

Please Note: If you cannot find your manager listed above, please select the 'Manager not listed' option.
Your Correspondence Address Please enter your full work address and NOT your home address
Address Line 1:
Address Line 2:
City / Town:
Postcode:
Telephone:
Additional Info  
Are you responsible for line managing / supervising staff?  Yes
Full Time or Part Time:  
Bank Staff:  
Shift Worker:  
Do you have any special needs that may affect your participation in learning opportunities e.g hearing impairment, wheelchair user, dyslexia?  
 
Please give details:
  Please tell us if there is anything we can do to ensure you are able to access the learning opportunity or the learning material?
Provide learning materials in advance:  
Ensure induction loop is available:  
Provide signing services:  
Other:  
 
Please give details:
   
 

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