* = required fields
Title * -Please Select- Mr Miss Ms Mrs Other
Name *
Address Enter address...
Postcode *
Tel no. *
Mobile no. *
Email *
Date of birth *
National Insurance Number
Where did you hear about Carshalton College *
Previous school attended
Address of present or previous school Address of present or previous school...
Gender * Male Female
Age Range * -Please Select- 16-18 19-24 25+
Have you been a resident in the UK for over 3 years? * Yes No
If no, please enter the following three questions
State which country *
Enter country of domicile *
Enter date of entry to UK *
Are you in receipt of any income based benefits? Yes No
If yes please state which income based benefits
Are you a British national, EU, EEA or other citizen with the right to stay in the UK? Yes No
If no please state which citizenship
Title of next of kin * -Please Select- Mr Miss Ms Mrs Other
Next of Kin Name *
Contact number for next of kin *
Only fill out this section if you are applying for work based learning i.e Apprenticeships. If you are not applying for work based learning jump to qualifications
Company name
Address Enter company address...
Postcode
Contact name
Business no.
Email
Site address (where assessment will take place if different from above) Enter company site address...
Present job title
Date started
What are your main duties? Enter your main duties...
What qualifications do you wish to undertake? Enter qualifications you wish to undertake...
Qualification level
Do you have a contract of employment?
How many hours do you work per week?
How many years? experience in this type of work do you have?
Do you have access to a computer? Yes No
GCSE/O Level, 5 or more at grade A - C
GCSE/O Level, 5 or more at grade D - E
CSE 5 or more at grade 1
1 or more A Levels/GNVQ
2 AS Levels
BTEC First Diploma/GNVQ
BTEC National Certificate Diploma/AVCE
NVQ Level 2
NVQ L3
None
If you have ticked any of the boxes on the left, please list qualification title and date achieved
If you have ticked any of the boxes on the left, please list qualification title and date achieved List qualification title and date achieved...
Please list any other qualifications you have achieved
Please list any other qualifications you have achieved List other qualifications...
Please list any predicted grades
Please list any predicted grades List any predicted grades...
Do you consider yourself to have a disability? Yes No
If yes please tick relevant box
Visual impairment
Mental health
Severe learning difficulty
Hearing impairment
Other
Please state other Enter details of other learning needs...
Temporary disability
Dyslexia
Mobility
Moderate learning difficulty
Dyscalculia
Do you require support needs, if so please detail here Do you require support needs if so please detail here...
31 English/ Welsh/ Scottish/ Northern Irish/ British
32 Irish
33 Gypsy or Irish Traveller
34 Any other White background
35 White and Black Caribbean
36 White and Black African
37 White and Asian
38 Any other Mixed or Multiple ethnic background
39 Indian
40 Pakistan
41 Bangladeshi
42 Chinese
43 Any other Asian background
44 African
45 Caribbean
46 Any other Black/ African/ Caribbean background
47 Arab
98 Any other ethnic group
99 Prefer not to disclose
How we use your personal information
The personal information you provide is passed to the Chief Executive of Skills Funding and, where required, the Young People's Learning Agency for England ("the YPLA") to enable those organisations to fulfil their statutory obligations, principally under the Apprenticeships, Skills, Children and Learning Act 2009. Both organisations are registered as data controllers with the UK Information Commissioner's Office.
The Skills Funding Agency funds adult further education and skills training, including Apprenticeships, in England. The YPLA is responsible for arranging the provision of funding for the education and training of young people in England. The Skills Funding Agency processes learner data on behalf of the YPLA.
The information you provide may be shared with other organisations for purposes of administration, the provision of career and other guidance and statistical and research purposes, relating to education or training. Other organisations include the Department for Education, the Department for Business, Innovation and Skills, Local Authorities, Connexions, Higher Education Statistics Agency, Higher Education Funding Council for England, educational institutions and organisations performing research and statistical work on behalf of the Skills Funding Agency, the YPLA, or partners of those organisations.
The Skills Funding Agency also administers the learner registration service (LRS) which uses your learner information to create and maintain a unique learner number (ULN).
Further information about use of and access to your information is available at:
Skills Funding Agency: http://skillsfundingagency.bis.gov.uk/foi.htm
YPLA: http://www.ypla.gov.uk/foi.htm
At no time will your personal information be passed to organisations for marketing or sales purposes. The YPLA, the Chief Executive of Skills Funding and their partners may wish to contact you from time to time in respect of surveys and research to monitor performance, improve quality and plan future provision and to inform you about courses, or learning opportunities relevant to you.
Tick this box if you wish to be contacted in respect of surveys and research by mail or phone.
Tick this box if you wish to be contacted about courses or learning opportunities by post.
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