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Application Form

Personal Details


Title
Surname (Family Name)

First Forename

Other Forenames

Date of Birth

Legal Sex


Ethnic Group
First Language
Sexual Orientation
Contact Number (Home Telephone)
Mobile

E-mail address

Email (Please enter again)

Address Search

Enter your postcode below and press 'Search' then double click the correct address from the list to enter

Country
Postcode Field is Required
 

I don't know the postcode
Enter address manually / My address is not listed



Next of Kin / Emergency Contacts

Primary Contact

Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone number
Emergency Contact Email Address
Do you live with this person?
Address Line 1
Address Line 2
Address Line 3
Town/City
Postcode

Secondary Contact

Second Contact Name
Second Contact Relationship
Second Contact Phone number
Second Contact Email Address
Do you live with this person?
Address Line 1
Address Line 1
Address Line 2
Address Line 3
Town/City

Courses

Please select the course you would like to study.

Please Select

Disabilities, Medical Conditions and Learning Support Details

Do you have any disabilities, learning difficulties or mental health difficulties?
Primary Disability/Learning Difficulty/Mental Health Difficulty
Secondary Disability/Learning Difficulty/Mental Health Difficulty

Please provide any extra information you'd like us to know

Notes
Are you a wheelchair user?
Do you have a medical condition which may affect your learning?
Do you have an Education Health & Care Plan?
Do you need extra help with your course or at interview?

Are you currently in the care of the Local Authority?

Please tick if you are a Local Authority Looked After Child (16-18), unaccompanied asylum seeker or previously care experienced(e.g. in foster care, supported lodgings, residential care, special guardianship, in receipt of leaving care services or adopted)


Have you recently left Care?

Please tick if you are a Recent Care Leaver (18-25), unaccompanied asylum seeker or previously care experienced(e.g. in foster care, supported lodgings, residential care, special guardianship, in receipt of leaving care services or adopted)

Are you a young parent?

You're a young parent if you are under 18 and are the legal parent/guardian of a child



Criminal Convictions

Do you have any convictions, cautions, reprimands, final warnings or pending court cases which are not protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013)?

As a duty of care to staff and students, the College reserves the right not to enrol a person where there is evidence that they could be a threat or danger to others. Declaring convictions may not prevent you from being offered a place but failure to disclose something of which we later become aware could result in disciplinary action or your enrolment being cancelled. Please inform the College if the circumstances marked above change during your course. Please note: If you are applying for a course leading to working with children under 18, vulnerable adults, social services, uniformed services, teacher training or the health service you should ask at the interview for advice as certain convictions may affect future employment in these areas.


School

Please tell us your previous school - if you were home schooled, pelase select 'Home Schooled' from the list

Did you receive Free School Meals?

How did you hear about us?

Learning Agreement Declaration

Required consents

  • I confirm that before signing this form I have read the data protection policy and privacy notice and consent to the College processing my personal data including any sensitive data in accordance with the data protection principles.
  • I confirm that I have received, read and agree to abide by the terms and conditions of enrolment, I agree that all of the information on this form is correct.
  • I confirm that I have received appropriate advice and guidance prior to enrolling on this course and I understand that if I am 16 to 18 years old then English, maths and work experience form mandatory elements of my study programme and I will be required to undertake each of these where appropriate.

The College will

  • Send you information about your course. However we would also like to send you information about other learning opportunities, courses and events.

Where you are under the age of 18 the College will:

  • Provide my previous years education provider with information about my academic attainments for the purpose of evidencing educational destination and outcomes;
  • Provide my parent/guardian/carer with information about my attendance, behaviour, progress and achievement outcomes

ESFA Privacy Notice

This privacy notice is issued by the Education and Skills Funding Agency (ESFA) on behalf of the Secretary of State for the Department of Education (DfE) to inform learners about the Individualised Learner Record (ILR) and how their personal information is used in the ILR. Your personal information is used by the DfE to exercise our functions under article 6(1)(e) of the UK GDPR and to meet our statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009 Please see the full privacy notice here: https://guidance.submit-learner-data.service.gov.uk/ilrprivacynotice

LRS privacy notice

The information you supply is used by the Learning Records Service (LRS). The LRS issues Unique Learner Numbers (ULN) and creates Personal Learning records across England, Wales and Northern Ireland, and is operated by the Education and Skills Funding Agency, an executive agency of the Department for Education (DfE).For more information about how your information is processed, and to access your Personal Learning Record, please refer to: https://www.gov.uk/government/publications/lrs-privacy-notices

Confirmation