FRESH START
for entry in September 2014
PERSONAL DETAILS
Equal Opportunities Monitoring
(please complete in block capitals) Surname First Name Address
Dual Heritage White and Asian
Postcode Have you lived at this address for more than 3 years?
White and Black
Black or Black British African Caribbean
If not, please note previous address
Asian or Asian British Pakistani Bangladeshi Gender
Male
Female
FRESH START
The college is committed to Equality of Opportunity and welcomes applications from all learners irrespective of gender, sexuality, disability, race, belief or background (you can view our Single Equality Scheme on our website). We are legally required to obtain data on the ethnic origin of our students – please tick one box which you feel best describes you.
Other Black Indian
Other Asian
Date of Birth
White Irish
Email Telephone (Home)
British
Other White
Other (please specify, for example, Chinese)
Telephone (Mobile) Country of Birth Resident in the UK for the last three years or more at 1st September 2014? (must be completed) Yes No
CURRENT COLLEGE
Please tick if you speak English as a second language
What was your previous school?
Present College
Previous School
QUALIFICATION AIM(S) APPLIED FOR
CAREER IDEAS
Qualification aim(s)
(Level 2 Diploma, AS Level etc)
Subject
(English Language, Biology etc)
1
Please indicate your current intentions after College: Higher Education (e.g. university) Gap Year
2
Employment
Career Ambition (e.g. teacher, engineer, architect, lawyer)
3 4 5 6
QUALIFICATIONS
(list all you are entered for this year and any you have already obtained)
Qualification aim(s)
GCSE, BTEC, Level 2 Diploma, Short Course GCSE etc
1 2 3 4 5 6 7 8 9
Subject
English Language, Maths, Science etc
GCSE Grades
if already obtained and year obtained
Predicted Grade for 2014 If available