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Personal Details

Surname

This must be your legal surname as it appears on your birth certificate

First Name

This must be your legal first name as it appears on your birth certificate

Middle Name(s)

This must be your legal middle name as it appears on your birth certificate

Known as (First Name)
Previous name
Date Of Birth
Sex assigned at birth
Gender Identity
Preferred pronoun
Nationality

This must be your nationality that appears on your passport which is not necessarily your country of birth.

Address

Address1
Address2
Address3

Postcode

What is your country of residence?
Home telephone
Mobile Tel
Email
Email (enter again)
     
Will you have lived continuously in the UK for more than 3 years on the first day of your course?
Is Home Fees

Because you have not lived in the UK for last 3 years or more, we need to collect more information to determine your eligilbity for funding, please answer the questions below

Date of entry into UK

Parent/Carer & Emergency Contacts

Please provide details of two emergency contacts. We will use the information to contact a parent/carer about your progress, attendance, and to invite them to parents evenings


Emergency Contact Details

Emergency Contact Name (Full Name)
Emergency Contact Relationship
Emergency Contact Phone number
Emergency Contact Email Address
Are you living with this person?
Is Living With Contact1

Secondary Emergency contact details

Second Emergency Contact Name (Full Name)
Second Emergency Contact Relationship
Second Emergency Contact Phone number
Second Emergency Contact Email Address
Are you living with this person?
Is Living With Contact2

Further Details

What is your first language?
Ethnic Group
Religion

Are you a registered Young Carer?


You're a young carer if you help to look after a relative with a disability, illness, mental health condition, or drug or alcohol problem

Young Carer

Are you in Care?


Looked After

Were you previously entitled to free school meals?


FSM

Do you have a physical health need, disability, mental health, individual learning need or special exam arrangements?
Physical health need or disability

Please specify in as much detail as possible eg. Epilepsy, ME

Mental health need

Please specify in as much detail as possible eg. Anxiety

Individual learning need

Please specify in as much detail as possible eg. Dyslexia, Asperger Syndrome

Special exam arrangements

Please specify in as much detail as possible eg. Extra tine, screen reader

Do you have an educational health care plan?


Has Education Health Care Plan

Are you a wheelchair user?


Is Wheel Chair User

Education & Background

Previous school, College or HE institution

If you can't find your school, please enter the name below:

Would you be the first in your family to go to university

Please state if you have any criminal convictions or have any convictions pending

Please gives details of any convictions declared above

Please detail
How did you hear about us?

Qualifications

We need your expected or achieved qualifications to make sure you are applying for the right course. Please include information on all qualifications studied i.e. GCSE, BTEC diplomas, A-levels, NVQs. If you haven’t yet taken your exams, please provide your predicted grades. If you haven't taken your mock exams, please use your most recent teacher estimated grades.

Entering Maths & English Qualifications is mandatory

Ensure you have given us your grades for GCSE English Language, English Literature and Maths if you have achieved these qualifications.

Date Awarded - Don't worry if you don't know the exact Date Awarded - please use 1st July of the year that it was in.

Level - Please state the level of the qualification eg. GCSE, BTEC

If you have do not have any qualifications, then please press ‘No prior qualifications’. Use ‘Add row’ to save and add multiple qualifications.

To remove items, please press ‘No prior qualifications’ then press ‘Add Qualifications’

In the subject box - please select the name of the qualification




Subject
Grade
Date
Level
Predicted Grade

Can we contact your reference?

We need a reference to process your application. Please select 'Yes' if you would like us to contact your school for a reference and to give your consent for them to respond. If you do not agree, select 'No' and we will contact you to discuss an alternative reference

References

Please provide details of the person willing to recommend you. If you are still at school this must be an academic reference completed by your Head of Year or equivalent. Please note the referee must not be a relative. Failure to provide this information may result in a delay in the application being processed.



Referee Surname
Referee Forename
Tel
Email
Relationship to you
Referee Job Title

Consents

Please tick any of the below to give consent:

Do you agree to your photograph being used for publicity purposes

Do you agree with your work being used as example material

What careers have you considered

Please give the name of any other colleges to which you have applied, otherwise leave blank

Please comment on any interests you may have in or out of school eg. Sport played (be specific), drama, music (be specific) or any other activities you may be involved in

Is there anything else you wish to tell us about


Please confirm: