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Application Form

Step 1 of 6

Are you aged 19 or above?(Required)

Personal Details

Title(Required)

Name(Required)

First Name Surname

Date Of Birth(Required)

Legal Gender(Required)

Please ensure that the contact details you provide below are accurate, as this is how we will contact you.

Mobile Tel(Required)

Email(Required)

Enter Email Confirm Email

Further Details

Do you have any support needs, disabilities or learning difficulties?(Required)

Primary Disability/Learning Difficulty(Required)

Secondary Disability/Learning Difficulty

Do you have an EHCP? (Education Health Care Plan)(Required)

Please provide any extra information that can help us to help you

Are you currently in Care?(Required)

Have you ever been in Care?(Required)

Nationality(Required)

What is your ethnicity?(Required)

Have you ever been convicted of a criminal offence (not including motoring offences) or are you subject to an ongoing criminal investigation?(Required)

Primary Emergency Contact (Next of Kin) Only applicable for 16-18 year olds

Emergency Contact Name(Required)

First Last

Emergency Contact Phone number(Required)

Emergency Contact Email Address(Required)

Are you living with this person?(Required)

Emergency Contact Relationship(Required)

Secondary Emergency Contact Details (Please provide if possible, if you only have one emergency contact please leave blank)

Emergency Contact Name

First Last

Emergency Contact Phone number

Emergency Contact Email Address

Are you living with this person?

Emergency Contact Relationship

School details

Previous/Current School(Required)

Date From

Date To

Confirmation

Please take time to read through this declaration before proceeding

I understand that courses may be cancelled or re-scheduled if the required minimum enrolment numbers are not reached and that although information is correct at the time it is given, circumstances can lead to changes.

I understand it is important for the college to have up-to-date student records and I agree to inform my tutor if my address, telephone number or other details change.

I undertake to conform to the Regulations of the College. If tuition fees are not paid at enrolment, I agree to be invoiced.

I understand that for students under 18 years old on 1st September 2020, specified information, eg academic progress, unsatisfactory behaviour, will be provided to parents/guardians as a matter of course. For students reaching age 18 before the end of the course, such information will be provided to parents/guardians unless student specifically requests otherwise in writing to the group tutor. For students released or sponsored by employers to attend courses, specified information, eg academic progress, attendance, will be provided on request for students aged 14-16 released from school to attend courses, specified information eg. academic progress, attendance, will be provided to the school. I give my consent for the College to contact other FE or HE Institutions on completion of my course, to confirm my progression route.

Privacy

Further information about use of and access to your personal data, details of organisations with whom we regularly share data, information about how long we retain your data, and how to change your consent to being contacted, please visit: Coulsdon Privacy Notice Croydon and Coulsdon College additionally collects personal data about you as a learner for academic and administrative purposes relating to the course you are studying and so that we can provide you with advice, guidance and support. Croydon and Coulsdon College may also contact you from time to time about courses or learning opportunities that may be of interest to you and with regards to your progression and destination after you leave the course. Croydon and Coulsdon College may pass information to other individuals and organisations for the purposes of administration, statistical analysis and research, careers guidance and other guidance and support. Such parties include educational establishments, colleges, universities, admissions services for universities (e.g. UCAS), sponsors/employers (e.g. information on your attendance and progress where they are providing you with time off or paying your fees), prospective employers, local authorities and your parents or guardians. Except where Croydon and Coulsdon College has legal rights or obligations, Croydon and Coulsdon College will not disclose your personal information to any other party or for any other reason other than as set out on this form without your prior consent. By signing the consent statement you agree to the use of your personal information in this way. please visit Croydon Privacy Notice