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Adult Skills Eligibility Form 23-24
Adult Skills Eligibility Form 23-24
C Employment Status
SELECT ONE option that best describes this learner's employment status:
Employed for up to 10 hours per week Employed for 11-20 hours per week
Employed for 21-30 hours per week Employed for 30 or more hours per week
Self-employed for up to 10 hours per week Self-employed for 11-20 hours per week
Self-employed for 21-30 hours per week Self-employed for 30 or more hours per week
Not employed, looking for work and available to start Not employed, looking for work and available to start
for up to 3 months for 7-12 months
Not employed, looking for work and available to start Not employed, looking for work and available to start
for up to 13-24 months for 25-36 months
Not employed, looking for work and available to start Not Employed, not looking or not able to start work
If thisfor
registration is a36
greater than legal entitlement2; Go to Section
months
otherwise; Go to Section
2
includes Functional Skills Maths, Functional Skills English, and Essential Digital Skills up to and including level 2
H
D
E Co-Funding Options
TRUE
This Learner is eligible for co-funding and will be liable for 50% of the course fees, please fill out ONE SECTION below:
FALSE
✘
FALSE
The learner will apply for Learner Support due to The learner will pay the remaining 50% of course fees.
a financialFALSE
hardship to cover the remaining course fees. Please inform the learner that they will be contacted by Adult
The learner may be eligible to receive financial support that Learning Business Support within 6 weeks of the start of the
FALSE
will cover the remaining 50% of course fees, they may also be course to take payment.
FALSEwith childcare and travel.
eligible for support
Fill out the Financial Support Form before proceeding, the will For office use only
be assessed by FALSE
Business Support along with this form and a Amount to pay:
decision returned
FALSEto you, when this is complete, continue
below Reference:
Assuming theFALSE
learner is approved; Go to Section Signed:
Go to Section
Date:
FALSE
FALSE H H
FALSE
FALSE
The learner is released on temporary licence, studying The learner has decided to withdraw from the course.
a outside the prison environment, and not funded
by a the FALSE
Ministry of Justice. For office use only
FALSE
The learner will be eligible for full-funding and will not be Learner Withdrawn
required to pay any fees. Signed: Date:
FALSE
Go to Section Go to Section
FALSE
G H
FALSE
F Non-Funded Options
This learner is liable for the full cost of the course fees, please fill out ONE SECTION below:
The learner will pay the full course fees. The learner has decided to withdraw from the course.
Please inform the learner that they will be contacted by Adult For office use only
Learning Business Support within 6 weeks of the start of the
course to take payment. Learner Withdrawn
Signed: Date:
For office use only Go to Section
Amount to pay:
H
Reference:
Signed: Date:
Go to Section
H Declaration
The information collected in this form has been collected directly from the learner named above and any required evidence
mentioned above has been seen. In addition to this the following have been completed (tick if appropriate):
The Learner Record Service Portal has been checked, confirming the learner has not completed the learning with another provider
The Residential Eligibility Form is filled out (if applicable in Section )
The Learner Support Form is filled out (if applicable in Section ) B
Signed: Print Name: Date: E
The Learner Support Form is filled out (if applicable in Section )
Signed: Print Name: Date: E
Residential FALSE
Eligibility Form - to be completed by staff
This form needsFALSE
to be completed if the learner has selected the third option under Section on the Adult Skills
Eligibility Form. B
FALSE
FALSE
Has the learner been ordinarily resident in the UK or the EEA1 for the last 3 years?
FALSE
If NOT, how long has the learner been ordinarily resident in the UK or EEA1?
FALSE
Do any of the following
FALSE categoriesTRUE apply - please note: evidence will need to be provided:
Refugee Status Discretionionary Leave to Enter or Remain
FALSE
Exceptional Leave to Enter or Remain Indefinite Leave to Enter or Remain
FALSE FALSE
Humanitarian Protection Leave Outside the Rules
FALSE
Ukrine Family Scheme Ukraine Sponsorship Scheme (Homes for Ukraine)
FALSE
Ukraine Extension Scheme Section 67 of the Immigration Act 2016 Leave
FALSE
Calais Leave to Remain British Nationals Evacuated from Afganistan Under Operation Pitting
FALSEEvacuated from Afganistan by
British Nationals The husband, wife, civil partner or child of any of the first 9 points
FALSE before 6 January 2022
the UK government above
FALSE
FALSE
Is the learner an Asylum Seeker?
(only ask if none of the above applies, please note that an Asylum Seeker must have lived in the UK for 6 months or longer to be eligible)
(only ask if none of the above applies, please contact business support for a decision on the learner's specific circumstances)
1
EEA Countries:
Evidence Austria, Belgium,
Declaration (TICK allCroatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary,
that apply)
Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Slovakia,
Biometric
Slovenia, Spain,Residence
Sweden, UnitedPermitKingdom Letter from the Home Office
Other (please state):
(please contact business support if any other evidence is supplied)
Signed: Date:
Financial Support Form - to be completed by staff
FALSE
This form needs to be completed if the learner has selected that they would like to apply for financial support
under Section FALSEon the Adult Skills Eligibility Form.
E
FALSE
FALSE
Select all that apply:
The learner's
FALSEhousehold income is below £33,300 P/A (per year) in a single person household or below £38,300 in
a multi person household.
FALSE
The learner is the only adult in their household
FALSE
FALSE
Financial Assistance
FALSE is needed for (select all that apply):
Child Care Books and/or Resources
FALSE
Please complete the relevant sections below that the learner has indicated they require support with:
Train or Bus Fare Tuition Fees
FALSE
FALSE
FALSE
Childcare -please
FALSEfill in this section if childcare is selected above (please note Nurseries and Childminders must be OFSTED Regulated):
FALSE Name of Child Date of Birth Name of Childminder/Nursery
FALSE
FALSE
FALSE
Address of Childminder or Nursery:
Email Address of Childminder or Nursery:
The learner receives Early Education Entitlement (15 hours)
2-3 year funding Name: The learner is using early years funding at NALS
2-3 year funding Name: The learner is using early years funding at NALS
Books and/or Resources - please fill in this section if books and/or resources is selected above.
Select ONE option below:
The learner will purchase the books/resources themselves and supply receipts.
Books and resources will be purchased on the learner's behalf.
Resource ISBN1 (if applicable) Cost
1
ISBN: International Stadard Book Number
Bank Details - please fill in this section if the learner will be making a claim for resources, travel, or books. Please
ensure that the learner's bank accepts BACS payments. The bank account must be in the same name as the learner.
Name of Account Holder: Name of Bank:
Sort Code: Account Code Roll No. (Building Society Only):
Evidence Declaration (TICK all that apply) - all evidence must be dated within the last three months:
P60 Payslip Self-employed tax return
Employment Contract Certified accounts for current year
Other (please state):
Signed: Date:
Prior Attainment Examples
Entry Level (Diploma, certificate, basic skills, ESOL)
Level 1 (GCSE D-G, Level 1 Functional Skills or NVQ)
Level 2 (GCSE or O-Levels A-C, Level 2 Functional Skills or NVQ)
Full Level 2 (equivalent to 5 or more GCSEs at grade A* to C)
Level 3 (A-level, AS Level, Level 3 NVQ, Award, Diploma, certificate)
Full Level 3 (equivalent to 2 or more A-levels)
Full Level 3 (equivalent to 2 or more A-levels)
Level 4 (HNC, CertHE, Level 4 NVQ, Award, Diploma, certificate)
Level 5 (Foundation Degree, HND, DipHE, Level 5 Award, Diploma)
Level 6 (degree apprenticeship. degree with honours)
Level 7 (Masters Degree, PGCE, Postgraduate Award, Diploma, certificate)
Other Qualification, Level Not Known (for instance qualifications awarded outside the UK)
Refugee status
Discretionary leave to enter or remain
Exceptional leave to enter or remain
Indefinite leave to enter or remain[footnote 5]
Humanitarian protection
leave outside the rules
Ukraine schemes:
individuals with leave to enter or remain in the UK under the Ukraine Family Scheme
individuals with leave to enter or remain in the UK under the Ukraine Sponsorship Scheme (Homes for
Ukraine)
individuals with leave to enter or remain in the UK under the Ukraine Extension Scheme
The husband, wife, civil partner or child of anyone in the first 7 bullet points of this list
Section 67 of the Immigration Act 2016 leave [footnote 6]
Calais leave to remain[footnote 7]
Afghanistan schemes:
British Nationals evacuated from Afghanistan under Operation Pitting
British Nationals evacuated from Afghanistan by the UK government before 6 January 2022
Children of Turkish workers
A child of a Turkish worker is eligible if both the following apply:
the Turkish worker is ordinarily resident in the UK on or before 31 December 2020 and has Turkish
European Community Association Agreement (ECAA) rights or extended ECAA leave and
the child has been ordinarily resident in the UK, EEA and/or Turkey for at least the previous 3 years on
the first day of learning and is resident in the UK on or before 31 December 2020
Asylum seekers
Asylum seekers are eligible to receive funding if they:
have lived in the UK for 6 months or longer while their claim is being considered by the Home Office,
and no decision on their claim has been made, or
are receiving local authority support under section 23C or section 23CA of the Children Act 1989 or
the Care Act 2014
An individual who has been refused asylum will be eligible if:
they have appealed against a decision made by the UK government against granting refugee status and
no decision has been made within 6 months of lodging the appeal, or
they are granted support for themselves under section 4 of the Immigration and Asylum Act 1999, or
are receiving local authority support for themselves under section 23C or
section 23CA of the Children Act 1989
Persons granted stateless leave
A person granted stateless leave is a person who:
has extant leave to remain as a stateless person under the immigration rules (within the meaning given
in section 33(1) of the Immigration Act 1971), and
has been ordinarily resident in the UK and Islands throughout the period since the person was granted
such leave
To have an eligible residency status, a stateless person must:
be ordinarily resident in the UK on the first day of the first funding year of the course, and
have been ordinarily resident in the UK and Islands throughout the 3-year period preceding the first
day of the first funding year of the course
in section 33(1) of the Immigration Act 1971), and
has been ordinarily resident in the UK and Islands throughout the period since the person was granted
such leave
To have an eligible residency status, a stateless person must:
be ordinarily resident in the UK on the first day of the first funding year of the course, and
have been ordinarily resident in the UK and Islands throughout the 3-year period preceding the first
day of the first funding year of the course
Certain family members are also eligible under this category if:
the spouse or civil partner of a person granted stateless leave (and who was the spouse or civil partner
of that person on the leave application date), who is ordinarily resident in the UK on the first day of the
first funding year of the course, and who has been ordinarily resident in the UK and Islands throughout
the 3-year period preceding the first day of the first funding year of the course, or
the child of a stateless person or of the stateless person’s spouse or civil partner (and who was the child
of that stateless person or the child of the stateless person’s spouse or civil partner on the leave
application date), was under 18 on the leave application date, is ordinarily resident in the UK on the
first day of the first funding year of the course, and has been ordinarily resident in the UK and Islands
throughout the 3 year period preceding the first day of the first funding year of the course
“Leave application date” means the date on which a person is granted stateless leave made an
application to remain in the UK as a stateless person under the immigration rules (within the meaning
given in section 33(1) of the Immigration Act 1971).
Individuals who are not eligible for funding
You must not claim funding for individuals who do not meet the eligibility criteria set out in the
residency eligibility section. Examples of individuals who do not meet the eligibility criteria include
the following. Please note this list is not exhaustive:
those who are here without authority or lawful status
those who are resident in the UK on a student visa unless they are eligible through meeting any other
of the categories described above
those who are in the UK on holiday, with or without a visa
any family member of a person granted a student visa, who have been given immigration permission to
stay in the UK and have not been ordinarily resident in the UK for the previous 3 years on the first day
of learning
those whose biometric residence permit or residence permit imposes a study prohibition or restriction
on the individual