Enquiry Form - Part Time Courses

Part Time Enrolment Form

Please note - you should only complete this form and submit it to us if you are going to be paying the course fee and any other related fees in full by credit or debit card. We shall then call you within 5 working days to confirm the booking and take your card details.
If you are claiming any discount please come in to the college with your original benefit letter.
If you wish to discuss fees or discounts please call us directly on 0845 300 4401.

Please write in the programme details here
Course Title	Day	Time	Enrolment Code	Start Date

Additional Learning Support

In order to assist your learning, Northampton College will attempt to make all reasonable adjustments for learners with learning difficulties and/or disabilities.

Do you have a learning difficulty?
YesNo If yes, please give details

Do you require assistance with this while you are at College?
YesNo If yes, please give details

Do you have a disability?
YesNo If yes, please give details

Do you require assistance with this while you are at College?
YesNo If yes, please give details

Please give the name(s) of any Support Workers/Key Workers who can give us more information:-

Name:

Tel:

Organisation:

We will also contact your previous school for information which will enable us to plan any extra support for you.

Employment Details

Employer Role A19
Learner is enrolled and released by the employer to study
The employer has not released the learner to attend
Learner is attending dedicated employment provision
None

What is your employment status prior to starting course?

EmployedStill at School
Full Time EducationUnemployed
Self EmployedNot Economically Active
Other
If Other, please state

If you are employed, please select one of the following

Your employer has no involvement in your study
You are released by your employer to attend college
You are not released by your employer to attend college
You are attending a programme specifically set up for your employer

What is the highest level of qualification you have obtained prior to starting the course?
Level	Examples
None
Entry Level Qualification	Literacy/Numeracy
Other Qualifications below Level 1
Level 1	5 GCSE's (including O Levels), Grades at D-G (or fewer than 5 grades at A-C), CSE below Grade 1, GNVQ Foundation, NVQ1
Level 2 Full	5 GCSE's (O Levels)at Grades A-C, 1 GNVQ Intermediate, First Diploma, 1 A Level, 2/3 AS Levels, NVQ2
Level 3 Full	2 or more A Levels, 4 or more AS Levels, AVCE, Access to Higher Education, National Certificate/Diploma, ESOL, NVQ3
Level 4	Teaching Qualification, HNC, HND, Advanced Diploma, First Degree, NVQ4
Level 5	Higher Degree, NVQ5, High Level Professional Qualification
Other Qualifications, level not known	Please state:

Disclosure

Northampton College is an inclusive College and we are keen for all students to be well cared for. We therefore ask all learners to declare if they have any unspent criminal convictions. If you answer yes, you will be asked to provide further details. This does not automatically affect your admission but allows the College to undertake a risk assessment and provide support as appropriate.

Do you have any unspent criminal convictions? YesNo

If yes - please give the name of your contact at either Probation Service or Youth Offending Team:

We may contact the above person to enable us to complete a risk assessment

Marketing and Research
Please tick the boxes if you do not wish to be contacted about other courses or learning opportunities:
	By Email
	By Post
	By Telephone
Please tick the boxes if you do not wish to be contacted for surveys and research:
	By Email
	By Post
	By Telephone

Send your enrolment request