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Care Form
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HCPA TSI Training Partnership 2010/11Please complete, sign and date this form and return it by post or pdf to the address at the foot of the page
Form 4 Partnership FormNMDS-SC Ref No:
116586To be completed by each member of the partnership
Your Organisation name: Please give the name of your Home/Branch and, if applicable, the name of yourorganisation/group
Gold Care Homes - Autumn Vale
Your contact name: Deby O'Hare
Name of Partnership/Lead Partner you are joining:
HCPA TSI Training Partnership 2010/11
Lead Partner: Hertfordshire Care Providers Association (HCPA)Your NMDS-SC registered address:Danesbury Park RoadWelwynHertfordshire Post code: AL6 9SNTelephone number: 01438 714491 Fax number: 01438 716877
Email address: [email protected]
Partner's Declaration:
My organisation/business is a member of this partnership and we are happy for the LeadOrganisation to sign the proposal on our behalf.
I understand that the Skills for Care funding is a contribution towards the cost ofindividuals in my organisation achieving relevant adult units of competence.
I understand that I have a responsibility to inform the Lead Partner of adult units achievedand any relevant information that they need to maintain financial probity and a clear audittrail on funding spent.
I can, where appropriate, fund the same candidate using other funding. (I understand thishas to be based on a shortfall in the funding and real cost and that no profit can be madefrom this contribution).
I am not funding individuals in this proposal with funding from other Skills for Care fundingpartnerships to which I might belong.
I understand that I am only able to claim for staff employed by this organisation. I understand that I must keep a clear and robust audit trail of the funding received from
Skills for Care. I have completed the NMDS-SC organisation questionnaire. I have updated my NMDS-SC organisational data. I will complete the required individual NMDS-SC worker records before claiming, or *We already completed entering/updating 90% of our NMDS SC individual worker records
Qfi-(DD/MM,fYY) I I *
Please delete/complete as appropriate
Name: (please print) MARGARET WALLBRIDGE Position in organisation OPERATIONSDIRECTOR
Signature: Date: 27 08 10
HCPA Ltd., Albany Chambers, 26 Bridge Road East, Welwyn Garden City, Herts AL71HLTel: 020 3167 4680 Email: [email protected]
HCPA TSI Training Partnership 2010/11Please complete, sign and date this form and return it by post or pdf to the address at the foot of the page
Form 4 Partnership FormTo be completed by each member of the partnership
NMDS-SC Ref No:116586
Your organisation name: P/ease give the name ofyour Home/Branch and, if applicable, the name of yourorganisation/group
Gold Care Homes - Halcyon Days
Your contact name: Dawn Richmond Turner
Name of Partnership/Lead Partner you are joining:
HCPA TSI Training Partnership 2010/11
Lead Partner: Hertfordshire Care Providers Association (HCPA)Your NMDS-SC registered address:The Old RectoryChurch LaneGraveley, Nr Stevenage Post code: SG4 7LUTelephone number: 01438362245 Fax number: 01438 312587
Email address: [email protected]
Partner's Declaration:
My organisation/business is a member of this partnership and we are happy for the LeadOrganisation to sign the proposal on our behalf.
I understand that the Skills for Care funding is a contribution towards the cost ofindividuals in my organisation achieving relevant adult units of competence.
I understand that I have a responsibility to inform the Lead Partner of adult units achievedand any relevant information that they need to maintain financial probity and a clear audittrail on funding spent.
I can, where appropriate, fund the same candidate using other funding. (I understand thishas to be based on a shortfall in the funding and real cost and that no profit can be madefrom this contribution).
I am not funding individuals in this proposal with funding from other Skills for Care fundingpartnerships to which I might belong.
I understand that I am only able to claim for staff employed by this organisation. I understand that I must keep a clear and robust audit trail of the funding received from
Skills for Care. I have completed the NMDS-SC organisation questionnaire. I have updated my NMDS-SC organisational data.I will complete the required individual NMDS SC worker records before claiming, or * We already completed entering/updating 90% of our NMDS-SC individual worker records
on (DD/MiwvY) 27 708 / 10 *
Please delete/complete as appropriate
Name: (please print) MARGARET WALLBRIDGE Position in organisation OPERATIONSDIRECTOR
Signature. Date: 2708 10
HCPA Ltd., Albany Chambers, 26 Bridge Road East, Welwyn Garden City, Herts AL71HLTel: 020 3167 4680 Email: [email protected]
HCPA TSI Training Partnership 2O10/11Please complete, sign and date this form and return it by post or pdf to the address at the foot of the page
Form 4 Partnership FormTo be completed by each member of the partnership
NMDS-SC Ref No:116586
Your Organisation name: P/ease give the name of your Home/Branch and, if applicable, the name of yourorganisation/group
Gold Care Homes - Queensway House
Your contact name: Chris Larner
Name of Partnership/Lead Partner you are joining:
HCPA TSI Training Partnership 2010/11
Lead Partner: Hertfordshire Care Providers Association (HCPA)Your NMDS-SC registered address:Jupiter DriveHemel HempsteadHertfordshire Post code: HP2 5NPTelephone number: 01442266088 Fax number: 01442 261818
Email address: [email protected]
Partner's Declaration:
My organisation/business is a member of this partnership and we are happy for the LeadOrganisation to sign the proposal on our behalf.
I understand that the Skills for Care funding is a contribution towards the cost ofindividuals in my organisation achieving relevant adult units of competence.
I understand that I have a responsibility to inform the Lead Partner of adult units achievedand any relevant information that they need to maintain financial probity and a clear audittrail on funding spent.
I can, where appropriate, fund the same candidate using other funding. (I understand thishas to be based on a shortfall in the funding and real cost and that no profit can be madefrom this contribution).
I am not funding individuals in this proposal with funding from other Skills for Care fundingpartnerships to which I might belong.
I understand that I am only able to claim for staff employed by this organisation. I understand that I must keep a clear and robust audit trail of the funding received from
Skills for Care. I have completed the NMDS-SC organisation questionnaire. I have updated my NMDS-SC organisational data. I will complete the required individual NMDS-SC worker records before claiming, or * We already completed entering/updating 90% of our NMDS-SC individual worker records
on (DD/MWYY) 27 708 / 10 *
Please delete/complete as appropriate
Name: (please print) MARGARET WALLBRIDGE Position in organisation OPERATIONSDIRECTOR
Signature: Date: 27 08 10
HCPA Ltd., Albany Chambers, 26 Bridge Road East, Welwyn Garden City, Herts AL71HLTel: 020 3167 4680 Email: [email protected]
HCPA TSI Training Partnership 2010/11Please complete, sign and date this form and return it by post or pdf to the address at the foot of the page
Form 4 Partnership FormTo be completed by each member of the partnership
NMDS-SC Ref No:116586
Your Organisation name: Please give the name of your Home/Branch and, if applicable, the name of yourorganisation/group
Gold Care Homes - Heath Lodge
Your contact name: Nicky McVeigh
Name of Partnership/Lead Partner you are joining:
HCPA TSI Training Partnership 2010/11Lead Partner: Hertfordshire Care Providers Association (HCPA)
Your NMDS-SC registered address:Danesbury Park RoadWelwynHertfordshire Post code: AL6 9SNTelephone number: 01438716180 Fax number: 01438 312587
Email address: [email protected]
Partner's Declaration:
My organisation/business is a member of this partnership and we are happy for the LeadOrganisation to sign the proposal on our behalf.
I understand that the Skills for Care funding is a contribution towards the cost ofindividuals in my organisation achieving relevant adult units of competence.
I understand that I have a responsibility to inform the Lead Partner of adult units achievedand any relevant information that they need to maintain financial probity and a clear audittrail on funding spent.
I can, where appropriate, fund the same candidate using other funding. (I understand thishas to be based on a shortfall in the funding and real cost and that no profit can be madefrom this contribution).
I am not funding individuals in this proposal with funding from other Skills for Care fundingpartnerships to which I might belong.
I understand that I am only able to claim for staff employed by this organisation. I understand that I must keep a clear and robust audit trail of the funding received from
Skills for Care. I have completed the NMDS-SC organisation questionnaire. I have updated my NMDS-SC organisational data.*I will complete the required individual NMDS-SC worker records before claiming, or* We already completed entering/updating 90% of our NMDS-SC individual worker records
on (DD/MiwvY) 2 7 / 0 8 / 10 *
Please delete/complete as appropriate
Name: (please print) MARGARET WALLBRIDGE Position in organisation OPERATIONSDIRECTOR
Signature: Date: 27 08 10
HCPA Ltd., Albany Chambers, 26 Bridge Road East, Welwyn Garden City, Herts AL71HLTel: 020 3167 4680 Email: [email protected]