Name:

Company

Department & Manager

Telephone No

Course

Course Date

Email Address:

Briefly describe your job.

How long have you been in this role?

New role
Over 6 Months
Over 2 years

How confident you are in speaking in front of others

Extremely Nervous
Apprehensive
Fairly Confident
Very Confident

If you have any worries about attending this course please let us know. This information will remain confidential between you and the trainer

Do you supervise other people?

Yes
No

Please state your reasons for attending this course

Training requested
Compulsory training organised by company
As a result of Personal Development Plan
Other

If you would like to provide us with any further imformation regarding your training please enter here.