This application form is for UK

Further Education students only.

Application Form for College Courses at ncn 2009

CALL CENTRE (ADMISSIONS), NEW COLLEGE NOTTINGHAM, STONEY STREET, THE LACE MARKET, NOTTINGHAM NG1 1NG TEL: 0115 9 100 100

Please read this form carefully. All applicants complete sections 1-11
Please complete all sections of this form using CAPITAL LETTERS and black or blue ink

1 If you have previously studied at New College Nottingham (ncn) please provide your ID Number (on your student card)

Title (eg. Mr/Mrs/Miss/Ms) First name(s) Last name

Address

Postcode:
Mobile: Tel:
Email:

Date of birth Male Female Age as at 31 August 2009

(eg: 31 01 58) Day Month Year

National Insurance Number If you do not have a National Insurance Number, please leave blank.
(eg: A B 1 2 3 4 5 6 X)
Unique Learner Number

2 Personal Identity 3 Support Requirements

How would you describe your Please answer Parts A, B and C. We require this information to ensure that any support you need is ready
ethnic origin or personal for you as soon as possible. Examples of support include providing handouts in a different format,
identity? (Please tick (✓) one) needing someone to take notes in class, and having access to specialist equipment, etc. If you do not
require support please also indicate this.
Asian or Asian British
A DISABILITIES (Please tick (✓) any box that applies to you) L15
11 Bangladeshi
12 Indian 01 Visual impairment (does not include 08 Temporary disability after illness/accident
13 Pakistani wearing glasses) (eg. broken leg)
14 Other Asian background 02 Hearing impairment (eg. may need a 09 Profound/complex disabilities
hearing aid or communication support) 10 Aspergers Syndrome
Black or Black British
03 Disability affecting mobility (eg. 90 Multiple disabilities
15 Black African wheelchair user) 97 Other – please specify:
16 Black Caribbean 04 Other physical disability (eg. cerebral palsy)
17 Any other black 05 Other medical condition
background a) Epilepsy/Diabetes b) Other
Chinese 06 Emotional/behaviour difficulties
07 Mental health difficulty (eg. depression) 98 No disability
18 Chinese

Mixed ethnic origin B LEARNING DIFFICULTIES (Please tick (✓) one) L16
19 White and Asian 01 Moderate learning difficulties 90 Multiple learning difficulties
20 White and Black African 02 Severe learning difficulties 97 Other – please specify:
21 White and Black 10 Dyslexia (difficulty with spelling)
Caribbean 11 Dyscalculia (difficulty with number work
22 Any other mixed and arithmetic)
background 19 Other specific learning difficulty
20 Autism Spectrum Disorder 98 No learning difficulty
White
23 White British C Please tick (✓) to receive information about:
24 White Irish Childcare Support Financial Support English Language Support
25 Other white background
Thank you for telling us about your support needs. We will send you information about our services.
Other ethnic groups
By law we need your consent to pass information about your support requirements to those staff who can
98 Any other background support you during your time at college. Please tick (✓) the relevant box below and provide your signature.
not included above
I consent to staff being informed about my support needs.
please indicate below:
I do not consent to staff being informed about my support needs and I understand
that this means the College may be unable to give me full learning support.

Learner signature Date

Please turn the page…

Diversity at ncn
The College has a commitment to equality of opportunity. Part of our commitment is to monitor data related to our students in terms of
their ethnicity and disability status. The information you provide will only be used to help us monitor whether all our students are given a
fair chance to succeed regardless of ethnicity and disability. It is essential that you complete sections 2 and 3 on the previous page to enable
us to continually ensure that our courses and services are accessible for all students and that all students are given the support they need to
succeed. Further information about the College’s diversity strategy is available from Student Service reception areas. Learners are advised
that ncn provides courses for 14-16 year olds and other vulnerable learners. If you have any queries, contact your campus reception.

4 Nationality/Domicile
What is your nationality? British Citizen EU/EEA* Other Please state your nationality
If ‘other’, what type of visa/leave to remain in the UK do you have?
EEA migrant worker Exceptional/discretionary Dependant visa Other (please state)
Indefinite leave to remain leave to remain/humanitarian Student visa
protection
Asylum seeker Work permit/visa
Marriage visa
Refugee Visitor/tourist

Date of entry into UK, if not born here

Which countries have you lived in for the last three years, ignoring holidays?
Austria Cyprus Estonia Germany Iceland Latvia Luxembourg Norway Romania Spain
* EU & EEA
Belgium Czech Republic Finland Greece Ireland Liechtenstein Malta Poland Slovakia Sweden
Member States Bulgaria Denmark France Hungary Italy Lithuania Netherlands Portugal Slovenia Switzerland

5 Which course would you like to study at New College Nottingham?

Please complete either box A or box B – whichever applies to you.
A The course I would like to study is: (If you are applying for ‘A’ Levels, please list the subjects.) B Not sure which course
you would like to study?
Would you like a guidance
interview to help you decide?
If yes, please tick (✔) here

Is this an evening course? If yes, please tick (✔) here Yes

If the course includes music, please state which instrument(s) you play:
If you would like to study hair, beauty or childcare, at which ncn campus would you like to study?

ncn Basford Hall ncn City (Adams) ncn Clarendon ncn High Pavement Sixth Form College ncn Hucknall

When do you wish to start your course? Month Year

6 Are you currently an ncn student? Yes No If ‘yes’, please confirm:

Full course title Course Tutor’s name

If ‘no’, do you have any previous qualifications in your chosen subject area? (please specify in the space below).

7 How did you find out about New College Nottingham (Please tick all that apply.)
Already at college School careers event Newspaper advert Employer
Newspaper article Job centre Radio advert Careers office
General web search Public library Website (direct access) UCAS
Telephone directory Open evening (see below) Through the post Other advertising
Friend/relative External organisation School adviser/tutor Postcard invitation

8 Which campus open evening did you attend?

ncn Basford Hall ncn City (Adams)* ncn Clarendon ncn High Pavement Sixth Form College ncn Hucknall
*including ncn Lace Market ‘A’ Level Centre and ncn Lace Market School of Art, Design, Fashion and Media

When was the open evening held? Autumn (October–November) Spring (January–March) Summer (April–May)
Did you attend the open days/evenings of any other colleges?

Yes No If ‘yes’, please specify

Which other colleges have you applied to? (please state)

9 Other relevant information

If you are applying for a work based learning programme, please tell us: Are you currently employed? Yes No

Name of employer/organisation

Job title/position
10 Personal Statement
We would like to know more about you; why you would like to do this course and about your plans for the future. Therefore, in your own
handwriting, please provide further relevant information about yourself, including information about voluntary work, hobbies, interests,
sports activities, etc. Continue on a separate sheet if required and attach securely to this form.

11 Please list all the examination subjects/qualifications already achieved or going to be taken.
It is very IMPORTANT this section is completed. Applications will be delayed without this information.

If you have no formal qualifications, please tick here

Subject Level Year Predicted Grade Achieved Grade

eg. BTEC First Diploma Travel and Tourism 2 1998 Merit Merit
eg. GCSE 2 1990 B B

If you are at school or in full-time education – please ensure sections 12–15

are fully completed by your teacher.
Mature applicants – please refer to section 16.
12 Reference Request Form (Students at school or in other full-time education should get this section
completed by your school/college.)
We require a reference to ensure you are guided to the right course and receive any support you may need. If you are currently not in
school or are having difficulty in getting a reference, please ring 0115 9 100 100 and ask for Admissions where one of our friendly
advisers will be available to assist you.
Reference for people still at school/college
Name of school/college

Address of school/college
Postcode:

13 Applicant Profile (please tick (✔) appropriate box) Excellent Good Average Poor
100–95% 84–75%Below
94–85% 84–75%
100–95% 94–85% Below
74%74% Motivation
Attendance Spoken communication
Punctuality Written communication
Excellent
Excellent Good
Good Average
Average PoorPoor Commitment to learning
Honesty Meeting deadlines
Self-confidence Presentation of work
Adaptability Ability to work as part of a team

Please turn the page…

14 General comments (Continue on a separate sheet, if required.)

15 Statement: I confirm that the information in sections 12–14 is correct. (To be completed by your school or college.)

Signed Date

Print name SCHOOL/COLLEGE

Position at
school/college
STAMP
If you are not at school or in full-time education – please complete section 16.

16 Referee for all applicants not currently at school/college (This should not be a relative.)

Name Position
Address
Postcode:

17 Signature
Signature of applicant (all ages)

Date

DATA PROTECTION STATEMENT 2008/2009

Data Protection Act 1998 – The information you provide on this form will be passed to the Learning and Skills Council (the LSC). The LSC is
responsible for funding, planning and encouraging education and training for young people and adults in England, and is registered under the Data
Protection Act 1998. The information you provide will be shared with other organisations for the purpose of administration, careers and other
guidance, and statistical and research purposes. Other organisations with which we will share information include, the Department for Children,
Schools and Families, the Department for Innovation, Universities and Skills, Connexions, Higher Education Statistics Agency, Higher Education
Funding Council for England, educational institutions and organisations performing research and statistical work on behalf of the LSC or its partners.
The LSC also administers the learner registration service (LRS) which will use your information to create and maintain a unique learner number
(ULN). The LSC is also a co-financing organisation and uses European Social Funds from the European Union to directly or indirectly part-finance
learning activities, helping develop employment by promoting employability, business spirit and equal opportunities, and investing in human
resources. Further information about partner organisations and the ULN and what they do, may be found at www.lsc.gov.uk/providers/Data/help/
and by following the links to data protection. Information may also be shared wth previous schools or colleges attended.
At no time will your personal information be passed to organisations for marketing or sales purposes. From time to time students are approached to
take part in surveys by mail and phone, which are aimed at enabling the LSC and its partners to monitor performance, improve quality and plan
future provision.
The College may share information with your parent(s)/guardian(s)/carer(s)/employer(s)/sponsor(s) regarding your application.
If you do not wish for such information to be disclosed about your application, please tick here.
Tick this box if you do not wish to be contacted by the LSC or its partners in respect of surveys and research. The LSC values your
views on the education or training which you receive, and will use these to help bring about improvements for learners in England.
The LSC or its partners may wish to contact you from time to time about courses, or learning opportunities relevant to you.
Please tick here if you do not wish to be contacted about courses or learning opportunities by post.

MIAP offers a Learner Registration Service to allocate Unique Learner Numbers (ULNs) which enable the individual to access a Learner Record
Service. The Learner Record Service will offer the Learner the facility to access their participation and achievement data via a website and to
share this with other organisations and individuals where permission is granted.
Individuals can opt out of sharing participation and achievement data with those organisations listed in section 537A of the Education Act.
Details of data sharing can be found at www.miap.gov.uk or by telephoning the MIAP helpdesk on 0845 602 2589.
Please tick this box if you wish to opt out of sharing participation and achievement data

Thank you for applying to New College Nottingham (ncn). Your application will be acknowledged within five working days.
Please send this application form to:
Call Centre (Admissions), New College Nottingham,
Stoney Street, The Lace Market, Nottingham NG1 1NG
Tel: 0115 9 100 100