Application Form | Bishop Challoner Catholic College

Personal Details

Surname

Forename

Date of Birth

Sex

Full Postal Address

Postcode

Home telephone number

Student mobile number

Have you previously been a student at Bishop Challoner Catholic College?

Yes No

Are you a British or EU citizen?

Yes No

Do you require a student visa to study in the UK?

Yes No

Will you have lived in the UK, EU or EEA for 3 years on 1st September 2017?

Yes No

Parents / Guardians

Name of Parent(s) / Guardian(s)

Address of Parent(s) if different to yours

Postcode

Daytime contact number

Mobile number

Emergency Contacts

It is essential that the college has details of two people we can contact during the normal college day in case of an emergency. One will be the parent/guardian above, please provide a second contact in case of an emergency:

Name

Relationship

Daytime contact number

Mobile number

Education

Please provide details of schools/colleges attended since Year 10

Schools	Date attended From	To

Add Another School

If you have left education please provide details of any employment or training you have undertaken:

Qualifications

Please list all qualifications achieved or to be taken:

Subject	Type of Course GCSE, BTEC Level 2/3, GCSE short course, AS/A2 Levels	Grade		Year taken / to be taken
Subject		Predicted	Actual	Year taken / to be taken

Add Another Qualification

Please add any additional qualifications you may have:

Subjects you wish to study at Bishop Challoner Catholic College?

Subject / Course	Level

Add Another Subject

How would you describe your ethnic origin?

What is your main language spoken at home?

Career Plans

Please detail any career plans you may have:

About You

Please list any achievements, positions of responsibility and interests:

Learning Support

The college will make reasonable adjustments to avoid disadvantage to students with learning difficulties and/or disabilities. Please tick if you have one or more of the following conditions:

asperger’s/autism

anxiety/emotional problems

emotional problems

sensory impairment

specific learning difficulty which may impact upon learning (such as dyslexia, dyspraxia, ADHD)

medical condition which may impact upon learning

Please state your condition(s):

Is English a second language?

Yes No

Please add any other information that you feel is relevant to your application:

How did you learn about the College/Course?

College Website

Connexions Adviser

Careers Officer/Teacher

Press Advertisement

Bus Advertisement

Friend/Relative

College Publicity Material

Talk by College Staff

Other

please detail

Have you attended an Open Evening at Bishop Challoner Catholic College?

Yes No

I confirm that I will be 16 or over on 31st August 2013

I confirm that my application has been agreed with my parent(s)/guardian(s)

Data Protection

The College collects information about all our students for various administrative, academic and health and safety reasons. Because of the Data Protection Act 1998, we need your consent before we can do this. Since we cannot operate the college without effectively processing information about you we need you to sign the following consent to process clause.

I agree to Bishop Challoner Catholic College processing personal data contained in this form or other data, which the college may obtain from me or other people whilst I am a student. I agree to the processing of such data for any purposes connected with my studies, for references or my health and safety whilst on the premises or any other legitimate reason.