Personal details 

 
 
 
First name*
 
 
 
 
Preferred name*
 
 
 
 
Last name*
 
 
 
 
Email:*
 
 
 
 
Telephone:*
 
 
 
 
Mobile number
 
 
 
 
 
 
Address line 1*
 
 
 
 
Address line 2
 
 
 
 
Address line 3
 
 
 
 
Town*
 
 
 
 
Postcode*
 
 
 
 
County
 
 
 
 
Country*
 
 
 
 
 
 
What is your date of birth?*
 
 
 
 
ULN (unique learner number if available):
 
 
 
 

Please let us know if you have already completed any units for this qualification previously.

 
 
 
 
 
Do you consider yourself to have any disability or medical condition that would mean that you would need reasonable adjustments to support your studies?*
 
Yes
No
 
 
 
If you selected yes to needing reasonable adjustments, please provide more details:
 
 
 
 
 
 
Which unit do you wish to apply for?*
 
 
 
 
Please select a start date:*
 
 
 
 

Please let us know if you have already completed any units for this qualification previously. 

 
 
 
Tell us the unit and date you completed:
 
 
 
 
Please tell us about any further information that you'd like us to consider:
 
 
 
 
 
 
How did you hear about this qualification? *
 
 
 
 

Please select a payment method

 
 
 
Payment options:*
 
 
 
 
 
 

If you selected invoice to employer please complete the following details, if you selected Visa/Debit/Credit Card please go to the next page.

 
 
 
Employer
 
 
 
 
Employer address
 
 
 
 
Purchase order number:
 
 
 
 
Authorised by (print name):
 
 
 
 
 
 

Declaration by applicant

 
 
 
I certify that the information given in this form is correct and fully completed.*
 
I agree
 
 
 

Where the fees are paid by your employer or a sponsor, CIH may provide details of your progress to them if requested and where CIH deem appropriate.

 
 
 
Do you allow us to provide details of your progress to your employer?
 
Yes, I agree
No, I do not agree
 
 
 

Please confirm you have read and understood our terms and conditions.  Please note that we cannot progress your application if you do not agree to the terms and conditions.

 
 
 
I have read and agree to the terms and conditions*
 
Yes
 
 
 
 
 

Data protection statement 

  1. CIH processes personal data in compliance with the General Data Protection Regulation (GDPR)(Regulation (EU) 2016/679) and the Data Protection Act.

  2. CIH will use your data for the purposes set out in its Privacy Policy found here.

 
 
 
Please state that you have read and understood the Privacy Policy*
 
True
 
 
 
 
 

By submitting your details to us from this form you are consenting to be contacted regarding your enquiry and opting into to receive marketing communications about relevant CIH products and services. View our full privacy policy here. 

 
 
 
Please tell us if you would like to stay informed about CIH membership:*
 
 
 
 
Please tell us if you would like to stayed informed about CIH products and services:*
 
 
 
 

CIH equality and diversity monitoring

The CIH Housing Academy is committed to ensuring that its services are accessible to everyone regardless of race, gender, ability, religion, sexual orientation or age. To help us to comply with ourpolicy ensuring equality in our services to you please could you complete our optional Equality and Diversity monitoring form using this link. The information you provide will be anonymous and you donot have to complete all of this form but it will help us improve our services if you can complete as much as possible.