Student Application Form

Enquire» Print» Email» Feedback»

You must give two references if you are applying for Childcare or Health & Social Care courses/apprenticeships where this is a requirement (please check the college prospectus or online course information pages). Otherwise you do not need to complete this section. References should not be family members.

Reference 1: Title: Mr Mrs Miss Ms Other

Name:

Address:

Telephone number:
Relationship to Student:

Reference 2: Title: Mr Mrs Miss Ms Other

Name:

Address:

Telephone number:
Relationship to Student:

Data Protection

Darlington College collects information on this application form for the following purposes:

To invite you into college for an interview
To apply to your school or employer for schools reports/or references
To provide feedback to your school, Connexions and the Local Authority
To contact you about information on courses. learning support opportunities and areas of support

The college can provide you with further information on course/learning opportunities.
Please tick this box if you wish to receive this information.

Data Protection Darlington College collects information on this application form for the following purposes:

To invite you into College for an interview
To apply to your school for a school report and/or references
To provide feedback to your school, Conexions and the Learning an Skills Council
To contact you about information on courses, learning support oportunities and areas of support

About You Please tell us why you are applying for this course or apprenticeship. Please include your strengths, relevant experience, career goals and work experience.

Are you a permanent resident of the European Union?
Yes No

For apprenticeship applicants only I require assistance from the college to find an apprenticeship job
I have an employment opportunity organised

Learning Support/Health If you consider yourself to have a learning difficulty, a disability, or other additional support needs and would like a member of our Additional Learning Support Team to contact you please tick the relevant box:

Support or special arrangements at interview
Additional support to study at college
Mentoring and/or support with personal difficulties

Have you ever been advised by a doctor to avoid any specific situation or working environment? (If YES please give details)

Equal Opportunities Please tick which box best describes your ethnic background (For statistical purposes only)

White/European
Bangladeshi
Indian
Pakistani
Other Asian background
African
Caribbean
Other Black Background
White/Asian
White/Black African
White/Black Caribbean
Other mixed background
Chinese
Other White Background
Prefer not to say
Other

Personal Details First Name(s):*
Surname:*

Title* Mr Mrs Miss Ms Other

Date of Birth:

House number/name: *
Street: *
Town: *
County: *
Postcode *
Home Number:
Mobile Number:
Email: *

Please remember to inform the college of your new address, telephone number or email address if your circumstances change. We may contact you via email and/or mobile phone to progress your application.

Courses/Apprenticeships* Would you like to study:

A Full Time Course
An Apprenticeship
A Part Time Course

Please type the title of the course/apprenticeship you are applying for (see college prospectuses or course information section of the website for more details)

Choice 1: *

Choice 2:

If you are unsure about your choice of course, please tick here for one of our Careers Guidance Advisers to contact you:

Education Details Please state the name and address of the school/college/institution you are currently at or have recently attended:

Name of School/College/Institution:

Address:

Date left/will leave:

Summary: Do you have or expect to achieve...
5 GCSEs at grade A* - C
4 GCSEs at grade D - E
Less than 4 GCSEs
No GCSEs

What overall results do you have or expect to achieve in your exams?

Subject

Level

Grade

Date of Exam

Maths Higher Foundation