16-19 full time application form - Cronton and Riverside College

Personal Details

Surname* First name(s)* Email address* Date of Birth* Age on 31st August 2017
Please enter only 2 digits (e.g 16)

Home Address*

Address* Postcode*

Your home telephone number Your mobile number
Gender If other please state:
Parent / Carer Name*: Parent / Carer Email:
Have you been a resident in the UK for the last 3 years? Select your country of origin

Previous Education

Name of school you attended in Year 11 School or college not mentioned above? Please type the name here: Have you ever studied at Cronton or Riverside College before? If so who was your Personal Tutor?

Course Details

What course/subjects would you like to study? Course Type Where would you like to study?*

Career Plans

If you know what career you are interested in, please provide details:

Additional Support

Do you have:

A disability (eg visual impairment, hard of hearing, mental health difficulty, epilepsy)
A learning difficulty (eg dyslexia, dyscalculia)
A major health condition that may affect your course

If so, please tick the box

You may be entitled to Student Bursary - Are you or your parents in receipt of:

Free school meals
Income support
Employment & Support Allowance
Disability Living Allowance

We will contact you to discuss your support requirements. Any information that you provide will be kept private and will not be passed to anyone without your consent.

Qualifications

Please list the qualifications you have, or are currently studying below:

Subject	Qualification (eg GCSE/BTEC)	Predicted Grade	Actual Grade	Year Taken (eg 2016)

Supporting Statement

Please include any further information about yourself to support your college application. (eg work experience, voluntary work, prefect, sports club, musical talents)

Equal Opportunities*

Riverside College and Cronton Sixth Form is committed to equal opportunities. We would like you to provide the following information to help us monitor our policy.

Verification and Data Protection:

I have checked these details are correct. I understand and agree to the College using this and other data to create and maintain records on me and for statistical purposes in accordance with the Data Protection Act 1998. I agree that this information will be kept for the duration of the application process and for a period of time thereafter.

This application is only to be completed if you are not already a student at the college and you wish to apply for a full time course starting in September 2017.

Please complete the details below. If you do not receive a confirmation email on submission of this form - check your spam folder.

If you are having trouble with your application - please contact admissions on 0151 257 2022 or email courses@cronton.ac.uk.

Personal Details

Home Address*

Previous Education

Course Details

Career Plans

Additional Support

Do you have:

You may be entitled to Student Bursary - Are you or your parents in receipt of:

Qualifications

Supporting Statement

Equal Opportunities*

Verification and Data Protection:

Please ensure you have filled in your email address. Please do not apply more than once as this will delay your application.

If you have previously submitted an application but would like to change your details, please contact us.

This application is only to be completed if you are not already a student at the college and you wish to apply for a full time course starting in September 2017.Please complete the details below. If you do not receive a confirmation email on submission of this form - check your spam folder.

If you are having trouble with your application - please contact admissions on 0151 257 2022 or email courses@cronton.ac.uk.

Personal Details

Home Address*

Previous Education

Course Details

Career Plans

Additional Support

Do you have:

You may be entitled to Student Bursary - Are you or your parents in receipt of:

Qualifications

Supporting Statement

Equal Opportunities*

Verification and Data Protection:

Please ensure you have filled in your email address. Please do not apply more than once as this will delay your application.

If you have previously submitted an application but would like to change your details, please contact us.

This application is only to be completed if you are not already a student at the college and you wish to apply for a full time course starting in September 2017.

Please complete the details below. If you do not receive a confirmation email on submission of this form - check your spam folder.