Learner Case Study Form

Please read Appendix 1 below before completing this form to understand how your information will be used. The Adult Education Budget (AEB) aims to engage adults and provide them with the skills needed for entering and sustaining work, an apprenticeship / traineeship, or other further learning. We are particularly keen to celebrate and champion the success of individuals who have had a positive experience as a result of participating on an AEB programme through telling their stories.

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Learner name
Are you happy to be contacted for a follow up?
Why did you choose this course?
By authorising below, you are giving consent for iMeta to share your personal information and experience as an adult learner.

I authorise the Imeta Training to use photographs/ images taken of me and my personal information in any publicity and marketing materials.

· I understand that this may include (but is not limited to) advertisements and other publicity materials such as leaflets, brochures and posters, direct mail, books,social media and publications for the Internet, including publications made in partnership with the West Midlands Combined Authority.

· I acknowledge that my participation is voluntary and that I will not receive payment of any kind in connection with the taking or publication of these photographs or participation in any marketing materials or other publications.

· I understand, acknowledge and agree that I do not own copyright or have any rights of ownership or other claim over the photographs/ images and have no right to royalties whatsoever. I confirm that I will not make any legal claim in relation to privacy, defamation or passing off in relation to any uses of the images provided they are used within the scope of this consent.

· I understand that the Imeta Training and Combined Authority will keep all the images and use them for a period of up to 6 years after which they will be deleted from the Combined Authority’s image bank.

· I understand that I have the right to withdraw my consent for the use of the photographs/images at any time by writing to Imeta Training. I understand that this means that images will be deleted from the image bank and not used for future publications but that publications containing images that have already been issues cannot be withdrawn.

· I understand that any views or personal information I provide which is captured by photography and/or video and this case study form will be made public via publicity and marketing materials and consent to this.

Appendix 1 – Privacy Information


Where the Imeta Training is planning to take and use still or moving images of identifiable individuals (“models”) or personal stories in publicity, including media case studies, consent must be obtained.

This form is designed to provide details about how your images and information will be used if you either model for, or share your story with, the Combined Authority.


The purpose of this form is to:

· provide you with information about how any images or your personal information will be used so you can make an informed decision before giving your consent;

· inform you of your privacy rights;

· record your consent

Why does the Combined Authority need images and personal stories?

We use images and personal stories to promote the organisation’s impact and the region.

Who should read this form?

This form should be read by anyone who has been asked to consent to either their image being taken, or to sharing their story for the purposes outlined above.

How are the images and personal information/stories used?

We use images and people’s personal stories in a range of materials to promote the work of Imeta Training and the West Midlands Combined Authority, This includes (but is not limited to): advertisements and other publicity materials such as leaflets, brochures, and posters; print, online and broadcast media; social media channels including Twitter, Facebook and Instagram, and on websites. We will only publish your name, location (town or city), the course you attended and your opinion of your experience as adult learner. We collect information about your age, nationality, and gender to ensure that the case studies we produce are diverse and reflect the West Midlands region.

Your contact information may be used to contact you about future opportunities or to obtain your consent for further marketing.

We do not supply images or information to third parties for profit or advertising purposes, nor do we profit from the use of images. We may share images with our stakeholders, partnership organisations such as local authorities for producing joint publications and with the course providers for marketing their own case studies.

How long does the consent last?

We will store and use images and your personal information for a period of 6 years after they are taken. After this time the images or personal information will be deleted from our records.

Please be aware that we cannot withdraw images from publications once they have been published and such publications may be kept indefinitely for archive purposes.

Who can give consent?

The Combined Authority takes the following approach towards consent:

· For models who are 19 years old and older and understand the consent process, the model can give consent and sign the form.

· For models who are 19 years old and older but have insufficient understanding of the consent process, consent must be given, and the consent form must be signed by a parent or legal guardian. However where possible the model will be engaged in the process and will be asked to countersign the form. Our representatives will be responsive to the feeling of the individuals involved and respect their wishes.

What if I change my mind?

You may withdraw consent at any time by writing/email to Imeta Training:

Data Protection Officer, Imeta Training Coach House 93A Hagley Road , Edgbaston B16 8LA

E-Mail: Tim.childe@imetatraining.co.uk

Tel: 0121 714 4129

Should you withdraw your consent we will delete your images from our image bank and provide written confirmation to you that this has been done. Please be aware that we cannot withdraw images from publications once they have been published and such publications may be kept indefinitely for archive purposes.

Data Protection

For the purposes of the Data Protection Act 2018 and the UK GDPR, Information provided to Imeta Training and the West Midlands Combined Authority will be processed based on consent in accordance with the information provided to you above.

As a data subject, however, you have a number of rights under the Data Protection Act and the upcoming General Data Protection Regulations including the right to access the information we hold about you. In some cases, you may have a right to have your personal data rectified, erased, or restricted, and to object to certain use of your data. You have an absolute right to demand that you stop receiving marketing information.

If you are unsatisfied with the way we collect or handle your personal data, you have a right to make a complaint to the Information Commissioner’s Office. Information about how to make complaints can be found on the ICO’s website at https://ico.org.uk.