Application Form:

Please complete the form below to apply for a course.

Have you studied at this college before?:*
YesNo

If Yes Supply your College ID Card Number if known.

Which course or subject do you want to study?:*

Which mode of study do you want?:*
Full time /16 hours per week
Part-time Day
Part-time Evening

Surname / Family Name:*

First Names:*

Date of Birth:*

Gender:*
Male
Female

Present Address:*

Post Code:

Telephone Number:

Borough:*

Are you willing to accept email / SMS text messages from us in the future?
Yes
No

If YES then please provide your:

Mobile No.

eMail:

Would you like to apply for a 'nursery' place for your child?
No Yes

Learning support needs:

Mental health service user

Wheelchair user

Visually impaired

Hearing impaired

Epilepsy

Other physical disability

Dyslexia

Other details:

How did you hear about the college:

This information will help us to arrange assistance for you.

Please provide a list of all qualifications already acheived:

Name of address of present / most present school or college (if attended within the last two years):

School / College Name:

School / College Address:

This section to be filled in by 16 - 19 year olds:

Attendance
Very Good Good Average Poor

Punctuality
Very Good Good Average Poor

Attitude to work
Very Good Good Average Poor

Suitability course
Very Good Good Average Poor

Accuracy of predicted grades
Very Good Good ` Average Poor

Please add any other comments:

Learners please note

Surveys and research
The LSC values your views on the education or which training you receive and will use these to help improve services for learners in England.

Please tick this box if you do NOT wish to be contacted by the LSC or its partners in respect of surveys and research.

Learning opportunities
The LSC and its partners may wish to contact you to tell you about courses or programmes, which may interest you.

Please tick here if you do NOT wish to be contacted about courses or learning opportunities by post.

* Obligatory fields

Thank you for completing the application form.

"Data Protection Act 1998" – The information you provide on this form will be passed to the Learning and Skills Council (the LSC). The LSC is responsible for funding and planning education and training for over 16-year-olds in England, and is registered under the Data Protection Act 1998. The information you provide will be shared with other organisations for the purpose of administration, careers and other guidance, and statistical and research purposes. Other organisations with which we will share information include, the Department for Education and Skills, Connexions, Higher Education Statistics Agency, Higher Education Funding Council for England, educational institutions and organisations performing research and statistical work on behalf of the LSC or its partners. The LSC is also a co-financing organisation and uses European Social Funds from the European Union to directly or indirectly part-finance learning activities, helping develop employment by promoting employability, business spirit and equal opportunities, and investing in human resources. Further information about partner organisations and what they do, may be found at http://www.lsc.gov.uk, and by following the links to data protection.

At no time will your personal information be passed to organisations for marketing or sales purposes. From time to time students are approached to take part in surveys by mail and phone, which are aimed at enabling the LSC and its partners to monitor performance, improve quality and plan future provision. The College collects all this information and more from all our staff and students for various administrative, legal, health and safety and academic reasons. The Community College processes this data in connection with your studies, and may send you prospectuses and evaluation questionnaires from time to time.