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Application Form

Please note that all fields on this form marked with a * must be completed in order to submit the form.

1. Personal Details

Title*

•    Mr
•    Ms
•    Other

If other, please specify

Surname*

Forename*

Date of Birth dd/mm/yy*

Mobile / Contact Number

Telephone (home)

 

Email Address*

Address*

Postcode*

 

Will you be over 19 on 01/09/20*

•    Yes
•    No

National Insurance Number (Apprenticeship Application Only)

Please note, over 19s may be liable for course fees

If you are aged between 16-18 or have an EHCP, by providing these details, you also consent to your parent/guardian being contacted about your application and any interviews at the College. In the event that we are unable to contact you directly, please provide their details below.

Parent / Guardian Name

Relationship to student

Parent / Guardian Mobile

Parent / Guardian Email

Parent / Guardian Address if different from above

Parent / Guardian Postcode

2. Course Applying For

Full Time / Part Time / Apprenticeship*

•    Full Time
•    Part Time
•    Apprenticeship

Please include the level and course title of the course(s) you wish to apply for.

First choice*

Second choice (if applicable)

Please tick which campus you wish to study at*

•    York
•    Newton Rigg
•    Middlesbrough
•    Saltaire
•    Wakefield
•    Newcastle

Please note, applications for all campuses are currently processed at our Newton Rigg campus, address at the end of this form.

We would also like to make you aware that, in principle, the Newton Rigg campus will close from July 2021 subject to consultation.

3. More About You

Are you applying as an international student?

•    Yes
•    No

Student support: we want to make sure that you succeed right from the start.

Please let us know if you consider yourself to have a disability, learning difficulty or any special educational needs.

I have a learning difficulty and/or disability

•    Yes
•    No

I have special educational needs

•    Yes
•    No

I have an Educational Health and Care Plan (EHCP)

•    Yes
•    No

Askham Bryan College welcomes applicants from ex-offenders and considers them on their merits. However, you are required to tell us about any convictions which are not spent under the Rehabilitation of Offenders Act (1974)

Do you have any unspent criminal conviction(s) and/or prosecutions pending? *

•    Yes
•    No

Please note: you do not need to tick the yes box if your criminal conviction is spent as defined by the Rehabilitation of Offenders Act 1974.

Please let us know your ethnic origin, this is optional to help with College statistics, tick as appropriate

•    31 White British
•    32 White Irish
•    33 White Gypsy or Irish Traveller
•    34 White any other White background
•    39 Asian or Asian British Indian
•    40 Asian or Asian British Pakistani
•    41 Asian or Asian British Bangladeshi
•    42 Asian or Asian British Chinese
•    43 Asian or Asian British - any other Asian background
•    44 Black or Black British – African
•    45 Black or Black British – Caribbean
•    46 Black or Black British - any other Black background
•    47 Arab
•    35 Mixed - White and Black Caribbean
•    36 Mixed - White and Black African
•    37 Mixed - White and Asian
•    38 Mixed - any other mixed background
•    98 Any other ethnic origin

Please make sure that you have double checked that you meet the minimum entry criteria for the course(s) you are applying for.

All applications are shortlisted based on the information you provide in this section.

If you are currently awaiting the results of a qualification please provide the predicted grade.

If you have already achieved a result then please provide the grade and year achieved (use an additional sheet if necessary).

Please complete as many lines as necessary

4. Qualifications

Level / Award (e.g. GCSE/BTEC)

Subject

Predicted Grade

Achieved grade / Year achieved

Qualification Level (1)

Subject (1)

Predicted Grade (1)

Achieved Grade (1)

Qualification Level (2)

Subject (2)

Predicted Grade (2)

Achieved Grade (2)

Qualification Level (3)

Subject (3)

Predicted Grade (3)

Achieved Grade (3)

Qualification Level (4)

Subject (4)

Predicted Grade (4)

Achieved Grade (4)

Qualification Level (5)

Subject (5)

Predicted Grade (5)

Achieved Grade (5)

Qualification Level (6)

Subject (6)

Predicted Grade (6)

Achieved Grade (6)

Qualification Level (7)

Subject (7)

Predicted Grade (7)

Achieved Grade (7)

Qualification Level (8)

Subject (8)

Predicted Grade (8)

Achieved Grade (8)

Qualification Level (9)

Subject (9)

Predicted Grade (9)

Achieved Grade (9)

Qualification Level (10)

Subject (10)

Predicted Grade (10)

Achieved Grade (10)

Please check you meet the entry requirements for the course you are applying for.

Please enter as many qualifications as you feel relevant. Please include your Maths and English GCSEs

5. School / Employment Details

Name of current school / college / employer

6. References

All applicants must provide 2 referees, if currently in education at least one referee must be from your school or college.

Please note, references are not accepted from close relatives.

By providing these details, you are giving your consent for them to be contacted prior to your interview at the College.

Referee 1 Name

Referee 2 Name

Referee 1 Position

Referee 2 Position

Referee 1 Address (Including School or Company Name)

Referee 2 Address (Including School or Company Name)

Referee 1 Postcode

Referee 2 Postcode

Referee 1 Email Address

Referee 2 Email Address

We would like to keep in touch with you to update you on College news, events and important applicant deadlines:*

•    Yes - please use my contact details to keep me informed
•    No - I do not wish to be contacted about College information and events

Data Protection Statement

I agree to the College processing my personal and sensitive data to assess my application and shortlist interviewees. I also agree to the College sharing my details with relevant organisations to support my application. The College retains Personal Data for at least 1 year for unsuccessful applicants and at least 6 years from completion of course for successful ones. The College holds Personal Data in accordance with the College data retention policy which is available at https://www.askham-bryan.ac.uk/the-college/college-policies. All data will remain at all times within the UK and European Economic Area (“EEA”). You can withdraw your consent for this processing at any time (though this may have consequences for your application). If you have any concerns about the way Askham Bryan College is using your Personal Data, you can contact the College’s Data Protection Officer, judith.clapham@askham-bryan.ac.uk. If you are still not satisfied with the response, you may then wish to contact the Information Commissioner’s Office at https://ico.org.uk/concerns/.

8. Signature (All applicants to complete)

I agree that the information provided on this form is accurate and true.

I have read and agree with the statements above.

Signature of applicant (Entering your name here qualifies as a digital signature)*

Date (dd/mm/yyyy)*

Printed or paper copies of this form should be returned to:

The Applications Team, Askham Bryan College, Newton Rigg Campus, Penrith, Cumbria, CA11 0AH or scan by email to applications@askham-bryan.ac.uk

Applications submitted online will automatically be sent to the Applications Team - you do not need to do anything else.