Adult Application Form Adult Admissions, Runshaw College Step 1 of 2 50% TitleMrMrsMissMsSurname*First Name(s)*Previous Surname(s)GenderMaleFemaleDate of Birth* Current Age*Address* Street Address City County Post Code Email address* Telephone NoMobile NoHave you been permanently resident in the UK or an EU country for the last three years?*YesNoUnique Learner Number (if known)If you do not have a Unique Learner Number you will need to bring either a passport, driving licence, your National Insurance card or a bank/credit/debit card for identificationNational Insurance NumberCourse applied forPlease select the course you wish to study:*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that students who do not attend for the first two weeks and make no contact with the college, will automatically be withdrawn from their course. QualificationsPlease state below any qualifications you have, and/or examinations you are taking. Please attach any supporting letter or CVAll QualificationsSubjectYear of EntryResult (if known)Estimated GradeDate Expected Further informationPlease state your reasons for applying for this course. Please include your career aims, interests and relevant work experience. Continue on a separate sheet if necessary.Your 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 detailsAttendanceRegular 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.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?*College PublicationPoster / LeafletRecommendationNewspaper AdvertSocial MediaRadio AdvertCareers ServiceEmployerDirect Enquiry to CollegeCollege WebsiteCollege EventOther, please specifyPlease select all that applyConsentI 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 Name and Surname*CAPTCHAUntitled
