Unite National Education course | Access Requirements form

Unite Education courses: Accessibility requirements form

Use this accessibility requirements form to prepare for your Unite Education course.
Yes, please add details to my recordNo, do not add to my records
Your name*

PrefixFirst NameLast Name
Unite membership number*
Course title and venue
Your email address*
example@example.com
Your telephone number*
Any food allergies or dietary requirements

Please state below in full any food allergies or particular dietary requirements e.g. if Halal, please specify what you may or may not eat.
YesNo
Please state below in full your food allergies ⬇️
YesNo
Please state below in full your specific dietary requirements clarifying what you may or may not eat ⬇️
Accessible liftAccessible meeting roomAccessible toiletBlue badge parking spaceBrailleBritish sign language interpreterDocuments in large print/font sizeDocuments printed on coloured paperDocuments produced in electronic formatDyslexiaInduction loopLip readerNeurodiversityPalantypistPersonal assistant / facilitatorPersonal emergency evacuation plan (PEEPs)Provisions for guide dogStep free accessOther (please state)
Use own vehicleRail ticket/assisted travelTaxi – accessibleOther (please explain)
Accessible bathroomAccessible bedroomBathroom equipped with alarmGrab bars in bathroomInduction loopMid-height light switches and power outletsShared or additional accommodation for personal assistant / facilitatorText phone facilitiesWalk in showerWheeled shower chair and/or wall mounted shower seatOther (please explain)
General access requirements
Please outline above any other access requirements that you may need to participate in the course
- Please complete this form if you have any disability access or dietary requirements. Do also provide a full description of the reasonable adjustments needed to facilitate your participation in a Unite Education course.
  
  Unite Education may further contact you to discuss the adjustments that can be made to support you in your learning journey.
  
  Please note: It may be necessary to provide alternative education provision if your access needs cannot be met on the course for which you have applied.
- For full information regarding Unite’s data processing, your information rights and how to contact our data protection team, please see our up to date privacy notice or contact your regional office for a copy. Note section 3. in particular that explains how the information provided on this form is used for Unite Education Courses.
  - Any accessibility or adjustment information provided by you will be shared with the course tutor and/or external education, venue and/or accommodation provider(s) (if applicable and necessary to facilitate).
  - Any dietary requirements will be shared with the catering provider(s) (if applicable and necessary to facilitate).
  - The information provided by you on this form will be used for the purpose of aranging and delivering this training/course only and will not be stored on your membership record
- Should be Empty:

Unite Education courses: Accessibility requirements form

Any food allergies or dietary requirements