PCDL Application Form 2018/2019

 

Please ensure ALL fields are completed in full.
Failure to complete all fields could result in a delay in securing your place on the course



SECTION 1: Personal Details

Your forenames and surname must be the same as on official ID documents
Title:
Forename:  
Surname:  
Previous Name:  
Gender:  
Date of Birth:  
Please use the following format: DD/MM/YY.
Age on 1st Aug 2018:  

Address:  
  
Postcode:  
Tel (day/mobile):  
Emergency Name & Tel   
Email:   
Are you currently studying at another establishment? If so please provide details:
  

SECTION 2: Personal Details

Nationality:  
Have you lived outside the UK during the last 3 years?  

If YES where did you live?
Date of entry into the UK:
Please use the following format: DD/MM/YY.

What is your first language?
The following questions are required for statistical purposes by the Skills Funding Agency and we ask you to complete them as accurately as possible.

How would you describe your ethnic origin? Please tick one option:
White
31 English/Welsh/Scottish/Northern Irish/British
32 Irish
33 Gypsy or Irish traveller
34 Any other white background
Mixed/multiple ethnic group
35 White and black Caribbean
36 White and black African
37 White and Asian
38 Any other mixed/multiple ethnic background
Asia/Asian British
39 Indian
40 Pakistani
41 Bangladeshi
42 Chinese
43 Any other Asian background
Black/African/Caribbean/Black British
44 African
45 Caribbean
46 Any other black/African/Caribbean background

Other Ethnic group
47 Arab
98 Any other ethnic group
Your responses to the following questions will help us support you during your time at college. Please note that these questions will not affect your application.

Do you consider that you have a health problem?



Do you consider that you have a learning difficulty?



Would you like a member of staff to contact your prior to the course in relation to learning support?


Please enter details if you wish to give us more information:



SECTION 3: Qualifications

Please tick the box to indicate the level of your highest qualification


SECTION 4: Employment and Household Status

Are you:


Employed/Self Employed Unemployed and looking for work Unemployed and not looking for work Retired Single Parent
Seeking Political Asylum

If employed/self-employed, are you working: Less thank 16 hours per week 16-19 hours per week 20+ hours per week
If employed/self-employed, how many months have you been employed: Up to 3 4-6 7-12 Over 12
If not employed/self-employed, how many months have you been unemployed: Less than 6 6-11 12-23 24-35 over 35


Please tick the following statement(s) which apply to you:
No household member is in employment and the household includes one or more dependent children
No household member is in employment and the household does not include any dependent children
Learner lives in a single adult household, irrespective of their employment status, with one or more dependent children
None of the above applies

SECTION 5:

Where did you hear about the course?

Radio Advert Twitter / Facebook Returning Student Library
Customer Service Centre School Friend/Family Poster
Brochure Newspaper Other College Website

Use of Personal Information


The information provided on this form will be used by New College Stamford and Lincolnshire County Council (LCC) to process your enrolment, arrange funding for your course through the Skills Funding Agency (SFA), and to deliver the course. Further information can be obtained from the Data Protection Office at New College Stamford or the LCC website. The information will also be shared with the Learning Records Service to create and maintain a Unique Learner Number (ULN). Further information on this can be found at www.gov.uk/government/collections/learning-records-service

New College Stamford, LCC and the SFA may wish to contact you from time to time in respect of surveys and research to monitor performance, improve quality and plan future provision and to inform you about courses, or learning opportunities relevant to you.
I do not wish to be contacted in respect of surveys and research by the Lincs CC
I do not wish to be contacted about other courses, learning opportunities or events
If you indicate above that you are happy to be contacted please indicate with method(s) is your preferred method of contact:
Post Telephone Email

I have a previous conviction or a pending prosecution(s) for a violent or sexual offence:


Applications with previous convictions will be subject to a fair assessment process. If you have any queries please contact the Advice and Guidance Team on 01780 484 311

SECTION 6: Course Details

Please select what courses you would like to do below..
Option 1:
Option 2:
Option 3:

SECTION 7: Tuition Fees

Reduction in Tuition Fees


The Skills Funding Agency subsides the cost of all courses, and any tuition fees paid represent a portion of the cost. If you are claiming any reduction tick the appropraite box, but you MUST supply the relevant evidence before your application can be processed. A reduction of 50% in tuition fees applies if you are in receipt of one of the following benefits (original evidence must be supplied):

Job Seekers Allowance (JSA)
Employment and support allowance (work related activity group)
Offenders who are serving their time in the community
Asylum seeker (plese contact the College for further details)

A reduction of 25% in tuition fees applies if you are aged over 65 on the 31st August 2018 (evidence of your date of birth must be supplied” and then a check box with Aged over 65



Materials must be paid in full

Please record the full price of tuition or material fees and the amount you are paying. If you are applying for consessionary tuition fees (as listed in the brochure) then the original of your evidence MUST be supplied to the College, without this your application will not be processed.

Payment

Payment information will be sent to you in the post following your application.


Declaration

I declare that the information I have given on this form is, to the best of my knowledge, correct. I agree to abide by College regulations and notify the College of any change of details or circumstances. I have received sufficient guidance/assessments before my choice of course. I agree to the processing of this data, and the sharing of data as outlined on this form. I understand New College Stamford reserves the right to change its offer at any time and that there is a refund policy which may restrict my entitlement to a refund of fees. I understand that I am enrolling to a Skills Funding Agency (SFA funded course which could be used as a match funded and is therefore deemed part funded by the Europeon Social Fund (ESF).


Tick the box to agree: