Adult application form

Applicant Details

Title

Gender

First name

Surname

Telephone

Alternate telephone number

Email address

Date of birth

Postcode

Please start typing your postcode in the box below and choose the correct address from the list. Your address will be filled in automatically

Address

Nationality

Ethnic origin

Have you been a resident in the UK, EU or EEA continuously for the previous 3 years?

If No, please state how long you have been resident

Courses applied for

Course One

Course Code

Course Name

Course Two

Course Code

Course Name

Qualifications

Qualification Name

Qualification Grade

Date Achieved

GCSE English

Qualification Grade

Date Achieved

I do not have this qualification

GCSE Mathematics

Qualification Grade

Date Achieved

I do not have this qualification

GCSE Science

Qualification Grade

Date Achieved

I do not have this qualification

Please list any other qualifications you feel may be relevant to your course choice (e.g. O Levels, CSEs):

Please advise of any relevant work experience you may have

Additional Information

I have a learning difficulty, disability or health needs which affects my ability to study

I require additional support

How did you hear about our courses?

Privacy Notice

The college will process the information provided in this form for the purposes of progressing your application or for education, training and administration purposes. We might share this information with third-parties, for example, your school, Connexions, ESFA or prospective employers for apprenticeship applicants.

Information will be processed in accordance with the college’s data protection policy. For more information about how we manage your personal data and your individual rights please visit the college's website www.burycollege.ac.uk.