Course Vacancy Application
To: The Worshipful Company of Spectacle Makers'
Apothecaries' Hall, Black Friars Lane, LONDON, EC4V 6EL
Tel: 020 7236 8645 or Fax: 020 7329 3249
(Registered Charity No 313784)
Print this form by clicking on PRINT in the command bar above
Name:.......................................................................................( Mr Mrs Miss Ms)
Ethnic group identifier....................... (See below) Membership No. ABDO................. Optom...................
Address: (To which Course Material is to be sent)
.................................................................................................................................................................
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Day Tel No:...............................................
Name & Address of Employer:..................................................................................................................
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.................................................................................................................................................................
Course Title: (In full)...............................................................................................................................
Course Code:.......................... Course Dates:.................................... Location:.......................................
COURSE FEES (SMC training vouchers may be exchanged for all courses)
Enclosed is a cheque to cover:
Course Fee (Less applicable discounts) ______________
Residential Accommodation
If for London - List preferred option........................*		 __________________
OR Non Residential Accommodation # ______________
Total
______________
 
Signature:....................................... Date:............................... Supervisor:.........................................
 
All cheques to be made payable to the 'Worshipful Company of Spectacle Makers'
* i.e. for Bed & breakfast in a single room at the Tavistock Hotel enter 1E, for Business Mans' tariff in a Twin/Double at the President Hotel enter 4C
# £28 per day - covers morning coffee & biscuits, 3 course lunch, afternoon tea & biscuits + room facilities
 
Ethnic Groupings
We are requiured by Statutory Obligation to seek this information. Please indicate, by entering one of the following numbers (taken from the Government Statistical Services list) in the section above:
Indicator
Number
Ethnic Group
Indicator
Number
Ethnic Group
10
 White, UK Heritage
30
 Indian
11
 White, European
40
 Pakistani
12
 White Other (Known)
50
 Bangldeshi
19
 White, Type Not Known
60
 Chinese
20
 Black, Caribbean Heritage
90
 Other (Known)
21
 Black, African Heritage
98
 Student not prepared to say
22
 Black, Other