Learner Application Form

Learner Details

Full Name (required)

Email Address (required)

Telephone Number (required)

Please select which course/s you are interested in (required)

Independent Domestic Violence Advocate (IDVA)Independent Stalking Advocacy Specialist (ISAS)Independent Sexual Violence Advisors (ISVA)Young Person Violence Advisor (YPVA)

Place of Work (required)

Current Work Role (required)

Please tell us the County in which you work (required)

Please list any previous work experience you believe is relevant to the qualification, including your experience supporting survivors of domestic and sexual abuse (required)

Do you have at least one years’ experience of working with domestic abuse survivors? (required)

Please list any previous qualifications and training (required)

Please tell us why you want to complete this course (required)

Please tell us where you heard about completing qualifications with Safer Places (required)

Funding Details

How will the qualification be funded? (required)

Self fundedFunded by current employer

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