Full Time Application Form

Please note - you should only complete this form if you wish to be invited for interview.

Please choose the course title here
Enrolment code:  
Why have you chosen this learning programme?(Please type a maximum of 1 sentence)



What do you want to do next (Study or type of employment)?(Please type a maximum of 1 sentence)



If you are applying for an A2 course, please contact the enrolment centre
AS-Level subjects to be taken:

Learner Details
Surname


Forename(s)


Title
  Other (please state) 

Gender
Date of Birth (dd/mm/yyyy)


Age on 1st September 2014


Home Address


Town


Postcode


Your Mobile Tel No


Your E-Mail Address (please enter in the exact format)


 
Please Confirm Your E-Mail Address


 
 
Next of Kin Full Name (for emergencies)

I agree to details relating to my application being shared with the next of kin I have named.

Relationship to You


My next of kin lives at the same address as me
Only complete if you will be 16-18 on 1st September 2014
Next of kin address
Next of Kin Contact Tel No


Second Next of Kin Full Name (for emergencies)

I agree to details relating to my application being shared with the next of kin I have named.

Relationship to You

Second Next of Kin Contact Tel No

Your Previous Surname (If Applicable)

National Insurance Number
Your Daytime Tel No


Your Evening Tel No


Residency in the UK/EU for three or more years?  
If less than three years, where did you live before this?


What is your Nationality?


What is your normal country of domicile?


If you are not an EU national, please answer the next three questions. Are you an Asylum Seeker?

Do you have a Home Office Letter?

Do you require a Student Visa?

*If you are a non-UK or non-EU passport holder you must submit a copy of your passport or Home Office letters with this application. You can do this by email to enquiries@northamptoncollege.ac.uk or by visiting the Enrolment Centre at any college site.

Equal Opportunities
Northampton College has a policy to promote Equal Opportunities in all its work.
Please assist us to monitor whether this policy is working by selecting your ethnicity.







Do you live in Hostel Accommodation?

How did you hear about the College
Please help us to improve the effectiveness of our marketing by telling us what first prompted you to enquire about these courses





If other, please specify
Please tick the boxes if you do not wish to be contacted about other courses or learning opportunities:
Please tick the boxes if you do not wish to be contacted for surveys and research:

Disclosure

Northampton College is an inclusive college and we are keen for all students to be well cared for. We require 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. If you fail to declare any unspent criminal convictions we reserve the right to review any offer of a college place.

Do you have any unspent criminal convictions?

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

Are you in care or leaving care this year?


Your education
What is the name of your current or most recent school/college?


Start year:

End year:
Subject Level Achieved/Estimated Grade Year Achieved

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.

1) Do you have a learning difficulty or disability?

If yes, please give details


2) Do you have a Statement of Special Educational Need?

3) Do you have an S139a Assessment?

4) Are/were you on a Special Needs Register at school?

Any additional literacy, numeracy, language (ESOL) needs will be assessed when you start a course at college

As you ticked yes Additional Learning Support, please give us some extra information so that we can offer the best support for you.

School contact?

Please tell us why you need extra support in College. If it helps there is a list of possible reasons below so you can say which apply.

Main support reason

Or tick below if you wish:

All difficulties/disabilities

Formal Dyslexia diagnosis?

Hearing impairment?

Did you have help at your last school

What do you think you might need help with at College

Do you have a Connexions Advisor

What is his/her name

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

  Name Tel Organisation
Worker 1
Worker 2
Worker 3

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


Send your application form