End-Point Assessment Registration Form

Are you interested in VetSkill providing your end-point assessment? Please complete this form to register your intent to contract with VetSkill for end-point assessment. Each agreement requires a separate registration form.

VetSkill will send an EPA agreement to you within five working days of receipt of this form. The information you provide is essential and will be relied upon by VetSkill; please give staff contact details, access to systems and relevant documentation, apprenticeship certification and invoicing.

Training Provider Name

UK Provider Reference Number

If not currently set up as a UK provider, please use this box to advise of the status.

Company Registration Number

Registered Charity Number

If applicable

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Telephone Number

General Email Address

Website

http://

Management Contact Name

Provide the details for person responsible for the apprenticeship standard end-point assessments.

First Name

Last Name

Job Title

Telephone Number

Mobile Telephone Number

EPA Booking Contact Name

This is the sole contact for EPA booking codes and confirmations. Ensure this email address is monitored and checked regularly for correspondence. This contact will be given access to the EPA hub.

First Name

Last Name

Job Title

Telephone Number

Mobile Telephone Number

Finance Contact Name

This contact is for invoicing. Apprentices are not permitted to book or take their EPA without VetSkill receiving full payment. See the VetSkill EPA Manual and individual standard EPA agreements for further information.

First Name

Last Name

Telephone Number

VAT Registration Number

Additional Training Provider Personnel

If you require additional personnel to access the EPA hub and assessment results please add their details below.

Authorised Contact Print Name

I declare that I am authorised by the above training provider to supply the information given above and, at the date of signing, the information provided is a true and accurate record to the best of my knowledge. Printing your name here acts as a signature.

Training Provider

Job Title

Date

YYYY

End-Point Assessment Registration Form

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