Adult Application Form Adult Admissions, Runshaw College Step 1 of 2 50% TitleMrMrsMissMsSurname* First Name(s)* Previous Surname(s) GenderMaleFemaleDate of Birth* DD slash MM slash YYYY Current Age*Address* Street Address City County Post Code Email address* Telephone No*Please provide at least one contact number.Mobile NoEmergency ContactEmergency Contact Name* First Last Relationship to Applicant*Please describe your emergency contact's relationship to you. Emergency Contact No.*This will only be used in an emergency situation. It is your responsibility to advise us if it changes.Employment StatusEmployment Status* Unemployed Employed Length of Unemployment* Unemployment Benefit Claimed*JSAUniversal CreditESA (WRAG)Not in receipt of benefitsOther state benefit - please stateOther state benefit - please provide details* Employed*Please select your employment status: Self-employedEmployedNot in paid employment/not looking for workFull-time education or trainingAged 14-19 and not in education, employment or trainingHow many hours per week do you work?* Household Situation*Please indicate which of the following apply Household all unemployed Only adult (18+) in household Dependent children in household (0-17 or 18-24 if full time student or inactive) None of these statements apply I confirm I wish to withhold this information Have you lived in the UK for the last 3 years?* Yes No IF No, please tell us in which country you previously lived and the date you came to live in the UK. (Further documentation may be required if you are an EEA citizen or Non EEA Citizen)National Insurance Number* Unique Learner Number (if known - if you do not have a Unique Learner Number you will need to attach ID below) Please attach one of the following forms of ID under the 'Identification' box: Passport, Driving Licence, Birth or Marriage Certificate, Citizen Card or NI Number Card. If you do not have a Unique Learner Number you will need to attach ID below. Please contact us if you do not have any of these items.Identification*Accepted file types: jpg, gif, png, pdf, Max. file size: 80 MB.Course applied forPlease indicate if you are a new applicant or an existing student progressing to a new course:*New applicantExisting student/progressionPlease select the course you wish to study:*AAT Level 2 - Foundation Certificate in AccountingAAT Level 3 - Advanced Diploma in AccountingAccess to Higher Education: Nursing and Midwifery / Health & Social Care Level 3Access to Higher Education: Social Sciences (Psychology, Criminology & Sociology) Level 3Access to Higher Education: Paramedic Science Level 3Assistant Accountant Level 3 ApprenticeshipProfessional Accounting Taxation Technician Level 4 ApprenticeshipApprenticeship Accounts & Finance with AAT Level 2Business Administrator Level 3 ApprenticeshipEarly Years Practitioner Apprenticeship Level 2Early Years Educator Level 3 ApprenticeshipCertificate in Counselling Skills Level 2 CPCABCertificate in Counselling Studies Level 3 CPCABDiploma in Therapeutic Counselling Level 4 CPCABCustomer Service Specialist Level 3 ApprenticeshipCustomer Service Practitioner Level 2 ApprenticeshipDigital Marketer Level 3 ApprenticeshipDigital Marketing Skills Bootcamp Digital Support Technician Level 3 ApprenticeshipEnglish Functional Skills Level 1 & 2Essential Digital Skills (EDSQ) Maths Functional Skills Levels 1 & 2GCSE English LanguageGCSE MathematicsHospitality Level 2 – Hospitality Team MemberHospitality Level 3 Apprenticeship – Hospitality SupervisorLevel 3 HR Support ApprenticeshipCIPD Foundation Certificate in People Practice Level 3Associate Diploma in People Management Level 5 CIPDProduction Chef Level 2 ApprenticeshipCatering Level 2 Apprenticeship – Commis ChefSupporting Teaching and Learning NCFE CACHE Level 2 CertificateDiploma in Supporting Teaching and Learning NCFE CACHE Level 3Teaching Assistant Level 3 ApprenticeshipTeam Leader/Supervisor Level 3 Apprenticeship QualificationsPlease state below any formal qualifications (GCSE, O Level, A Level, HNC/D, BTec, Degree) and/or examinations you are taking or are about to take. Please attach any supporting letter or CV. Please check the entry requirements for your course and add any required qualification/s below.GCSESubject (e.g. Maths)Year of EntryResult (if known)Estimated GradeDate Expected A LevelSubject (e.g. Maths)Year of EntryResult (if known)Estimated GradeDate Expected NVQSubject (e.g. Maths)Year of EntryResult (if known)Estimated GradeDate Expected HNDSubject (e.g. Maths)Year of EntryResult (if known)Estimated GradeDate Expected DegreeSubject (e.g. Maths)Year of EntryResult (if known)Estimated GradeDate Expected OtherSubject (e.g. Maths)Year of EntryResult (if known)Estimated GradeDate Expected Alternatively, upload a CV here:Max. file size: 80 MB.Further Information - Please state your reasons for applying for this course.Please include your career aims, interests and relevant work experience. Please indicate your preferred course day and time, if known.Nationality*United KingdomAlbaniaAlgeriaAfghanistanAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweYour ethnic origin*Asian or Asian/British -BangladeshiAsian or Asian/British - IndianAsian or Asian/British - PakistanAsian - otherBlack or Black British - AfricanBlack or Black British - CaribbeanChineseMixed White/AsianMixed White/Black AfricanMixed White/Black CaribbeanMixed White/OtherWhite - BritishWhite - IrishWhite - OtherAny other / Not knownAdditional supportDo you have a disability (e.g. physical or sensory, health, mental health, mobility, etc) or learning difficulty (e.g. dyslexia, etc) that we need to be aware of or that you will need support for on your course?Please give detailsDue to the current COVID situation it may be necessary for some lessons to be delivered online. If you have access to any of the below resources, please select each one: Laptop or PC Web Camera Microphone None of the above AttendanceRegular and punctual attendance is expected in order for you to achieve, progress and realise your full potential. Please provide details of any dates you will not be able to attend your course and the reason for the absence. You should include any planned holidays. Please note that students who do not attend for the first two weeks and make no contact with the college will automatically be withdrawn from their course. DBS checkPlease be aware that if your long term goal is to work in an area with vulnerable adults or any person under the age of 18, it will be necessary to undergo a Disclosure and Barring Service (DBS) check at your place of employment. If you have a criminal conviction this may exclude you from working in some job roles.How did you find out about the course? Please select all that apply*College PublicationPoster / LeafletRecommendationNewspaper AdvertSocial MediaRadio AdvertCareers ServiceEmployerDirect Enquiry to CollegeCollege WebsiteCollege EventOther, please specifyConsentI give consent to the processing of my data by Runshaw College and any other organisation which has a statutory right to receive any of it in accordance of the Data Protection Act 2018. I give consent to the processing of my data I would like to receive emails about further details of learning opportunities and associated events Written Full Name and Surname* CAPTCHA
