Name of school, nursery or setting where you will be attending the course *
Your answer
Please tick - Marvellous and Meaningful Maths *
If you can not attend day time sessions would you like to attend evenings from 7p.m online via our virtual classroom
First Name *
Your answer
Surname *
Your answer
Your own Date of Birth (Learner/parent). Please use format DD/MM/YYYY *
MM
/
DD
/
YYYY
Address Line 1 *
Your answer
Address Line 2
Your answer
Address Line 3
Your answer
Town *
Your answer
Post Code *
Your answer
County *
Your answer
Email Address *
Your answer
Tel: Number (Mobile). Please use format 00000 000000 *
Your answer
Do you consider yourself to have a learning difficulty and/or disability and/or health problem?
Clear selection
How did the learner hear of Multiply?
Clear selection
Primary Difficulty or Disability (if none tick N/A) *
National Insurance Number
Your answer
In receipt of State benefit
Clear selection
In receipt of Universal Credit
Clear selection
In receipt of Other State Benefits
Clear selection
Are you a UK national or other person with right of abode* AND lived in the European Economic Area (EEA) (including the UK) for at least the last 3 years?
Clear selection
*Are you a European Economic Area (EEA) national in the UK, you must have obtained either pre-settled or settled status under the EU Settlement Scheme# AND lived in the EEA (including the UK) for at least the last 3 years?
Clear selection
*Are you a non-UK national with one of the eligible immigration statuses below (tick the relevant status)?
Clear selection
Do you have Non-UK national Residency Status
Clear selection
Ethnicity
Clear selection
Are you happy to be contacted by Multiply Essex? *
Photo
permission: we sometimes
use photos/videos for publicity purposes. May we use your image(s) in our
marketing and promotion of TiEGr Multiply courses and share them with our
funder Essex County Council? Please note, you can withdraw your permission at
any time by emailing info@tiegr.org *
If I can not attend any sessions in person I would like to receive the recordings of the online sessions to watch in my own time *
A copy of your responses will be emailed to the address you provided.