SHEP Spring 2024 Community Education for Health & Wellbeing Short Course

 SHEP Cork Short (8 week) Community Education Courses

Spring 2024 Application Form

Applicant’s Name:

Address:

Home Phone:

Mobile Phone:_____________________ ______ E-mail Address:_______________________

Who to call in case of emergency: Name __________________ Number ___________________

Where did you hear about the courses? _____________________________________________

If referred to the course by another person, please specify? _____________________________

Why are you applying for the course? _______________________________________________

________________________________________________________________________________

Please specify if any special/medical needs that we should be aware of for practical purposes?

________________________________________________________________________________

Please specify any additional support you may need to participate (e.g. support with Zoom?)

_______________________________________________________________________________

If you wish, please provide a copy of welfare payment, as priority is given in allocating places

Please √ the Course Applied For (and 1 st & 2 nd preference if applying for more than one)

IN-PERSON – SHEP Project Centre, Ardfoyle, Ballintemple, Cork City (T12 Y304)

CN003871 – Managing Stress (Monday morning 10.30am to 1pm). – No Charge □

CN003872 - Seasons for Growth (Monday night 7.30pm to 10pm). – No Charge □

CN003874 - Effective Communication (Tues morning 10.30am to 1pm). – No Charge □

CN003873 - Introduction to PD (Wed night 7.30pm to 10pm). – No Charge □

CN003875 - Effective Communication (Thurs night 7.30pm to 10pm). – No Charge □

ON-LINE – Zoom On-line through SHEP

CN003877 – Managing Stress (Mon night 7pm to 9.30pm). – No Charge □

CN003876 - Introduction to PD (Wednesday nights 7.00pm to 9.30pm). – No Charge □

CN003878 - Seasons for Growth (Wednesday night 7.00pm to 9.30pm). – No Charge □

 Where a course is over-subscribed, we give weighting to a number of factors,

details of which are available on the website or by phone. Applicants will be

contacted a week in advance of the commencement date with offers of places

 On-line courses this Spring 2024, will have 14-16 participants max, and use

Zoom. Guidelines to all participants on accessing and using Zoom will be given

prior to course commencement - individual support is also available.

 Applicants need to be age 18 years or over. Where an applicant, or the Project

wish to check out readiness to participate on a particular course, the co-ordinator

will arrange to talk this through and maybe meet the person

 Please read info overleaf on ‘how we use personal data’ prior to signing

application. All above course tutor hours are CETB funded. Once course

commences, a registration form will also be asked to be completed.

Signature:__________________________________________ Date:_____________

Please return this Application Form to SHEP, Old National School, Ardfoyle Avenue,

Ballintemple, Cork (T12 XDH2) (021-4666180) or email to info@socialandhealth.com

How will SHEP use Personal Data of course

participants?

SHEP asks only for the minimum information from course applicants, sufficient enough to

process applications and course participations. You have rights in relation to your own

personal information used by SHEP, including right to object to processing and right of

access to your own personal information. We genuinely encourage you, if you have any

queries or concerns about how your personal data will used or stored, to talk with SHEP

training staff on 021 4666180 or email us at info@socialandhealth.com . SHEP’s purposes

for gathering information are:

 To contact you about your application; 


 To follow up with you after the application is received and administer your

application as required;

 To manage course processes (including commencement, completion, progressions,

course payments where relevant, course evaluations, project statistical reporting);

 To maintain your participant training record (including personal & course details)

 To share information with course facilitators, organisations involved collaboratively

in courses, or where there is a fee funding support being sought. Only necessary

information is shared and SHEP will be transparent with you.

 Where information is to be disclosed beyond the purpose above, specific additional

consent will be sought from you

Participant information is stored on secure, protected cloud based and in-house specialised

training and education database. Hard copy information is stored in secured cabinets.

Information is only accessed for the above purposes and only accessed by authorised SHEP

training, administration and accounts staff.

As an applicant for one of SHEP’s courses, we ask that you read and understand the above

data protection statement and application form carefully. On this application form we need

your signature to:

1. Confirm that you have read, understood and give consent to how SHEP will store, use

and access the personal information you provide.

We are committed to ensuring that any information we collect is handled in accordance

with the principles set out in the General Data Protection Regulation (Regulation (EU)

2016/679) and the Data Protection Acts 1988 to 2018. SHEP’s detailed Data Protection

Policy and time scales for retention of information is available at

www.socialandhealth.com