Foundation Diploma in Art & Design

COURSE APPLICATION FOR ENROLMENT IN THE ACADEMIC YEAR 2023-24.

Part 1 : Personal Details Part 1 : Personal Details First Middle Last
Your Date of Birth: Your Date of Birth: / DD / MM YYYY
Gender (at birth)

Gender (at birth) Female Male
Are you currently a New College Student?

Are you currently a New College Student? Yes No
If yes, what is your Student ID / Reference Number?
Your Personal Email Address:
Your Address Your Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Telephone :
Mobile Number :
An Emergency Contact Person - Their Name: An Emergency Contact Person - Their Name: First Middle Last
What relationship does this person have to you (i.e. mother, father, friend, etc.)?
Emergency Contact Address Emergency Contact Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Emergency Contact's Number 1:
Emergency Contact's Number 2:
Part 2: Difficulty, Disability or Health Problems

Do you consider yourself to have a learning difficulty and/or health problems?

Part 2: Difficulty, Disability or Health Problems

Do you consider yourself to have a learning difficulty and/or health problems? Yes No
If yes, please select conditions that are applicable to you:

If yes, please select conditions that are applicable to you: Asperger's syndrome Autism spectrum disorder Disability affecting mobility Disability (other) Other physical disablity Profound complex disabilities Dyscalculia Dyslexia Hearing impairment Mental health difficulties Learning difficulty (moderate) Learning disabilities (severe) Learning disabilities (Other) Other medical condition (e.g. epilespy, asthma, diabetes) Social & emotional difficulties Speech, language and communication needs Temporary disability after illness (e.g. post-viral) or accident Visual impairment Prefer not to say
The college is committed to ensuring that disabled people, including those with learning difficulties, are treated fairly. All reasonable adjustments to provision will be made to ensure that disabled students and other disabled people are not disadvantaged.
Part 3: Medical Conditions

Would you please indicate if you suffer from any allergies or illnesses e.g. asthma, epilespy, disabetes or any other condition you feel that we should be aware of:

Condition:
Do you carry any medication?
Part 4: Access Arrangements

Have you had access arrangements in exams (e.g. extra time, reader, scribe)?

Part 4: Access Arrangements

Have you had access arrangements in exams (e.g. extra time, reader, scribe)? Yes No
If yes, please provide details below:
Part 5: Educational History

What is the name of the school you attended:
What did grade did you achieve in GCSE English?
What did grade did you achieve in GCSE Maths?
Name of the last educational institution, your highest qualification and the grade(s) you achieved.

Example: New College Pontefract - A Level English - Grade A
Part 6: Ethnicity
(What would you describe yourself as)

Part 6: Ethnicity
(What would you describe yourself as) White - British White - Gypsy/Irish Traveller White - Irish White - any other Asian or Asian British - Bangladeshi Asian or Asian British - Indian Asian or Asian British - Pakistani Asian or Asian British -any other Black or Black British - African Black or Black British - Caribbean Black or Black British - any other Chinese Mixed - White & Asian Mixed - White & Black African Mixed - White & Black Caribbean Mixed - any other Other - Arab Any other Not known/not provided
Have you lived in the UK for 3 or more years.

Have you lived in the UK for 3 or more years. Yes No
Part 6: Criminal Convictions

Do you have any criminal convictions or cautions?

Part 6: Criminal Convictions

Do you have any criminal convictions or cautions? Yes No
If yes, please give further details:
Part 7: Privacy Notice
How we use your personal information (please read below)
The personal information you provide is passed to the Chief Executive of Skills Funding (“the Agency”) and, when needed, the Department for Education, including the Education Funding Agency to meet legal responsibilities under the Apprenticeships, Skills, Children and Learning Act 2009, and for the Agency’s Learning Records Service (LRS) to create and maintain a unique learner number (ULN) and a Personal Learning Record (PLR). The information you provide may be shared with other organisations for education, training, employment and well-being-related purposes, including for research. Further information about use of and access to your personal data, and details of organisations with whom we share data are available at www.gov.uk\government\publications\sfa-privacy-notice.
Part 8: Declaration
I declare that, to the best of my knowledge, the information I have given is correct and up to date. I agree to abide by the College rules and pay all course fees by the due date. I understand that the first 6 weeks as a student of New College is a probationary period. During this period, if your progress, attendance, or behaviour are of serious concern, the College reserves the right to take appropriate action which might include (but is not exhaustive) (a)withdrawal from College or; (b) extension of probationary period. Any decision to withdraw will follow a documented meeting with you. The College may not be able to provide services when there are circumstances beyond its control, including very severe weather, failure of supply services (e.g. power and water), changes in regulations or the law, industrial disputes, civil unrest or acts of God. I understand that the College cannot be held responsible for failing to provide any services in such circumstances. The College reserves the right to change the delivery location for HE courses.
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Date of Submission Date of Submission / MM / DD YYYY
Email
Email