HIGHER EDUCATION APPLICATION FORM

Course(Required)

Point of Entry(Required)

Name(Required)

Title First Last

Preferred first name

Previous surname

Legal Sex(Required)

Gender(Required)

Address(Required)

House Number Street Address City Postal code

Date of Birth(Required)

Phone(Required)

Mobile

Email(Required)

Planned fee payment method(Required)

Unique Learner Number

(if known)

BTEC registration number

(if known)

Did any of your parent(s)/carer(s) attend Higher Education previously?(Required)

Will you be living at home whilst studying?(Required)

Are you care experienced, e.g. previously looked after by a local authority?(Required)

Are you applying for a Teacher Training Qualification Only?(Required)

No

Yes

DBS Number

DBS Number date of Issue

Area of permanent residence(Required)

Country of birth(Required)

Nationality(Required)

Dual Nationality

Ethnicity(Required)

Residential Category(Required)

UK entry date(Required)

The TEC Partnership welcomes all applications and considers them on their individual merits. However, you are required to tell us about any convictions which are not spent under the Rehabilitation of Offenders Act (1974).

For some careers you will need to declare all criminal convictions including those that are spent.

Doing this will not necessarily stop you being offered a place on a course. Courses where a full disclosure is needed include those that could lead to a career in teaching or involve working with children or vulnerable adults, healthcare, the law/legal environment, accounting and finance, veterinary practices, RSPCA, taxi drivers, uniformed services and security.

If you are unsure about what to declare then please seek advice from our Safeguarding team 01472 311222 Ext 474/638 (you do not need to give your name) or ask a careers advisor at the National Careers Service at National Careers Service contact us.

For further information on what spent or unspent please see the link below.

https://www.nacro.org.uk

Are applying for a course that will require you to disclose any criminal convictions or outstanding investigations that could lead to a criminal conviction(Required)

Please Note: You do not need to select the Yes box, If your criminal conviction is spent as defined by the rehabilitation of offenders act 1974.

No

Yes

Do you have any unspent convictions, have pending prosecutions or current court proceedings?(Required)

Please Note: You do not need to select the Yes box, If your criminal conviction is spent as defined by the rehabilitation of offenders act 1974.

No

Yes

If you have answered yes to the previous 2 questions, a member of the Safeguarding team will contact you regarding your application. Please note that failing to complete this section or providing misleading or false information may lead to your application/enrolment being withdrawn.

Selecting ‘Yes’ to any of the questions above will result in a follow up meeting in order to obtain further details.

This is personal, sensitive information, and we require your consent before we can process your application.

Do you have any medical conditions/disablement?(Required)

No

Yes

If yes, you do have any medical conditions/disablement(Required)

Select from the list

Do you have a learning difficulty(Required)

No

Yes

If yes, you do have a learning difficulty(Required)

Select from the list

Education(Required)

Provider

Course

Award

Level

Grade

Date

Current Employer

Date employment commenced

Employer Address

Street Address City Postal Code

Employer Phone

Employer Email

Occupation / Duties

Please provide details of a referee who we can contact if required to support your application.

Your referee will typically be:

A tutor from your current or recent studies.
An Advisor who knows you well.
A current or former employer A family member or someone who is only a friend can’t act as your referee.

If you are not currently studying, your reference should be someone who is able to talk professionally about your application and potential, such as an employer or training officer. Your reference does not have to come from an academic source.

Referees Name(Required)

First Last

Referees Address(Required)

Street Address City Postal Code

Referees Phone(Required)

Referees Email

Referees Occupation(Required)

Referees Relationship to you(Required)

Mentor Details: (Only applies if you are applying for a Teacher Training Qualification)

Mentor Name(Required)

First Last

Mentor Address(Required)

Street Address Address Line 2 City Postal Code

Mentor Phone(Required)

Mentor Email

Mentor Position(Required)

Mentor Occupation(Required)

Personal Statement(Required)

Please use this space if you would like to provide a personal statement in support of your application. For example this may include skills, abilities, motivation, aptitudes, relevant work or voluntary experience, other prior learning and experiences, including those already achieved in the workplace.

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