Local Student Application
Personal Details Do you regard English as your second language
- Select - Yes No
Contact Details
Your Occupation Please state who is intending to pay your fees:
- Select - Career Development Loan Yourself Employer Student Finance Company Other
Qualifications Please give details of any qualifications already obtained, exams still to be taken or courses completed. Predicted grades to be entered by school/college referee
Higher Education/Training
Voluntary Work
Employment Supporting statement/experience relevant to course applied for:
Please help us to monitor our Equal Opportunities policy by completing this section
I consider my ethnic origin to be
- Select - English/Welsh/Scottish/Northern Irish/British Pakistani Irish Bangladeshi Gypsy or Irish Traveller Chinese Any other White Background Any other Asian Background White & Black Caribbean African White & Black African Caribbean White & Asian Any other Black/African/Caribbean Background Any other mixed/multiple ethnic background Arab Indian Any other ethnic group
Learning difficulty or any specific extra support requirements?
- Select - No learning difficulty (97) Other specific learning difficulty (19) Moderate learning difficulty (01) Autism spectrum disorder (20) Severe learning difficulty (02) Multiple learning difficulties (90) Dyslexia (10) Other (97) Dyscalculia (11)
Do you want to discuss your learning needs with a member of staf
- Select - Yes No
Do you have a disability or any specific extra support requirements?
- Select - No disability (98) Visual impairment (01) Hearing impairment (02) Disability affecting mobility (03) Other physical disability (04) Other medical condition Emotional/behavioural difficulties (06) Mental health difficulty (07) Temporary disability after illness (eg post viral) or accident (08) Profound complex disabilities (09) Aspergers syndrome (10) Multiple disabilities (90) Other (97)
Please state any specific extra support you may require:
Residency status Have you been permanently resident in the UK or EU for three years prior to 31st August (prior to course start date)?
- Select - Yes No
Please complete all relevant details: British National
- Select - Yes No
EU/EEA Resident
- Select - Yes No
Indefinite leave to remain
- Select - Yes No
Country of residence
Select Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belau Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Democratic Republic of the Congo (Kinshasa) Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Republic of the Congo (Brazzaville) Reunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (Dutch part) Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom (UK) United States (US) United States (US) Minor Outlying Islands United States (US) Virgin Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Visa type
- Select - Residence Visit
Employment status All Learners
- Select - In paid employment Not in paid employment, looking for work and available to start work Not in paid employment, not looking for work e.g. school leaver/retired and/or not available to start work In full time education or training prior to enrolment Employed for 20 hours or more per week Employed for 16-19 hours per week Employed for less than 16 hours per week Self employed
If employed, please state for how long
- Select - up to 3 months 4-6 months 7-12 months 12 months or more
If unemployed, please state for how long
- Select - less than 6 months 6-11 months 12-23 months 24-35 months 36 months or more I am in receipt of Job Seekers Allowance (JSA) I am in receipt of Employment and Support Allowance (ESA WRAG) I am in receipt of Universal Credit I am in receipt of another state benefit (other than JSA or ESA WRAG) I am not in receipt of any state benefit
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