Central College - Online Fulltime Application

Please enter your name and date of birth below,
then click the Check... button to view application status

First Name

Surname

Date of Birth
date month year

*Only the courses listed are available if course is not listed it is full. Please ensure you meet the specified entry requirements for your 1st choice of course..
1st

You will be considered for your 2nd choice of course if you are unsuccessful in gaining a place on your 1st choice..
2nd
*Only the courses listed are available if course is not listed it is full.

Title

First Name

Surname

Date of Birth
date	month	year	Sex	Nationality

National Insurance No.	Scottish Candidate No.

Home Address
(Line 1)	Tel
(Line 2)	Mobile
(Line 3)	(Postcode)
Email	(Please enter correct postcode format e.g G1 2TA)
Email

Correspondence Address (1)
Correspondence Address (2)
Correspondence Address (3)
Post Code
Tel No.

Date of Entry to UK (if applicable)
date	month	year

Which category below best describes your support needs? (Please tick)
No known disability
Asthma		Autism/Aspergers Syndrome
Diabetes		Dyslexia
Epilepsy		Hearing impaired
Learning Difficulties		Mental Health Difficulties
Mobility Difficulties		Visually impaired
Wheelchair User		Other (please specify below)

Please provide details, if any, of the support you may have previously received.

If you are selected for an interview, are there any facilities that may assist you? e.g. sign language interpreter.

To be completed by school leavers only
Did you receive support at school for any other reason such as: behavioural issues; bullying; attendance; young parent/carer; misuse of substances or alcohol; previously looked after by the local authority?
(Please select) Yes No (If yes please give details below)

If you have indicated a support need above, you will be contacted by our Learner Support Centre.

* Data Protection Act 1998: Information you provide in this section is classed as sensitive under the Data Protection Act 1998, and will be treated by us according to the law.

ETHNIC ORIGIN
White		Asian Asian Scottish or Asian British
Scottish		Indian
Irish		Bangladeshi
English		Pakistani
Welsh		Chinese
Other White background		Other Asian background
Black Black Scottish or Black British		Other Ethnic background
Caribbean		Other background
African		Mixed
Other Black background		Mixed background
Refused
Information refused

* Data Protection ACt 1998: Information you provide in this section is classed as sensitive under the Data Protection Act 1998, and will be treated by us according to the law.


Name


Year
From	To

Academic Reference (School leavers only should provide the name of an academic referee)

Length of time since in full time employment/since left full time education:

Please select from below if you intend to apply for financial support from:


Please include the word 'PENDING' under Grade/Band if you are awaiting results.

Qualifications/Subjects	Level	Completion Date	Grade/Band

List any information to support your application including practical experience, sport & leisure activities.
Mature students please give details of work experience since leaving school

(please indicate where you first learned about courses available at Central College)