Enrolment Form

"*" indicates required fields

Section 1 – Student - Personal Details and Term Time Address

Name*

Title First Name Surname

Gender*

Date of birth*

First Line of Address*

Second Line of Address*

Postcode:*

City*

Phone Number:*

Email*

Next of Kin Name:*

Next of Kin Relationship:*

Next of Kin Telephone*

Please indicate the type of accommodation you are living in during term time:

Section 1a – Student – Permanent Address Prior to Start (please provide your address prior to studying with us)

Address Line 1:*

Address Line 2:*

Address Line 3:*

Address Line 4:*

Postcode:*

Country:*

Section 2 – Student – Fee Status

2A) On the day you expect to start your course, will you have been ordinarily resident in the UK for at least the past three years?

2B) Have you applied for student finance e.g via Student Finance England?

If your answer is no, please indicate below the organisation or individual who will pay your fees: (e.g. self funded, employer)

If your answer is yes, please provider your Student Loans Company issued customer reference number (CRN):

2C) Do you require a student visa to study in the UK?

If you are not a British Citizen please provide the information requested below. If not applicable, please type N/A:

Immigration Status

Passport Number

Valid From (DD/MM/YY)

Valid To (DD/MM/YY)

Passport Country

VISA/BRP/Document Number

Valid From (DD/MM/YY)

Valid To (DD/MM/YY)

Section 3 – Student – Qualifications and Educational History

Is English your first language?

if not, please specify:

If you have taken a Test of English as a Foreign Language (TOEFL), BKSB or an International English Language Testing System (IELTS) test, please provide the details of this below:

Name and type of English Language Qualification

If you have taken a test, exam or qualification in Mathematics, please provide details of the highest level you have achieved below:

Name and type of Maths Qualification (e.g. GCSE Maths)

Please provide details of your highest level previous qualification of any type below including e.g. GCSEs (type “None” in subject if none previously achieved):

Name, Subject and type of Qualification

Based on the answer above, please select the level of your highest achievement prior to studying with us:

Please select the option below that best describes the education provider you have most recently attended before TEC:

Section 4 – Student – Employment History

You will be over the age of 21 at the date of your course start and do not have a qualification at or above level 3, please provide details of your current or most recent employment.

Job title

Organisation

Full time/Part time

Start Month/Year

End Month/Year

Section 5 – Student – Disclosure of criminal convictions

Spent convictions are defined by the Rehabilitation of Offenders Act 1974

Do you have any criminal convictions that are both relevant and unspent?

Section 6 – Learner - Equal Opportunities Monitoring

Trent Education Centre aims to have an inclusive environment for all staff and students, by identifying and removing barriers in our practices. Completing this monitoring form will help us achieve this, and also help TEC meet our obligations under the Equality Act 2010. While it is voluntary to disclose this information, doing so will enable us to better understand the composition of our workforce/student body and examine our practices fully. Your answers will be treated in the strictest confidence, and all data disclosed will comply with the Data Protection Act 1998.

Sex identifier - What is your sex?

Religion or belief - What is your religion or belief?

Parental Education - The following question is about your parent's level of education. This includes natural parents, adoptive parents, step-parents or guardians who have brought you up. Do any of your parents (as defined above) have any higher education qualifications, such as a degree, diploma or certificate of higher education?

Care leaver status - What is your care experience status?

Gender identity - Is the gender you identify with the same as your sex registered at birth?

Sexual Orientation - Which of the following best describes your sexual orientation?

Ethnicity – What is your ethnicity or ethnic group?

Under the Equality Act 2010 (England, Scotland, and Wales) and the Disability Discrimination Act 1995 (Northern Ireland), a person is considered to have a disability if they have a physical or mental impairment, and the impairment has a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. 'Substantial' is defined by as 'more than minor or trivial'. An impairment is considered to have a long-term effect if it has lasted for at least 12 months it is likely to last for at least 12 months, or it is likely to last for the rest of the life of the person. Normal day-to-day activities are not defined, but in general they are things people do on a regular or daily basis, for example eating, washing, walking, reading, writing, or having a conversation. Only serious visual impairments are covered by the legislation: for example, a person whose eyesight can be corrected through the use of prescription lenses is not covered; neither is an inability to distinguish between red and green. The same logic does not apply to hearing aids: if someone needs to wear a hearing aid, then they are likely to be covered. However, both hearing and visual impairments must have a substantial adverse effect on the ability to carry out normal day-to-day activities in order for a person to be covered by the legislation.

Considering the above, Do you have an impairment, health condition, or learning difference that has a substantial impact on your ability to carry out day-to-day activities and has lasted, or is expected to last, at least 12 months?

Section 7 – Learning Plan Aim Details (Staff completed)

Programme Title

Planned Start Date

Planned End Date

Contract

Section 8 – ELQ Equivalent or Lower Qualifications

Where a student is studying for a qualification equivalent to, or lower than, one they already hold, they may have limited access to student finance.

Do you hold a qualification at a level equivalent to or higher than the one you are enrolling for in the Learning Plan Aim details above?

Section 9 – Learner Funding Assessment Learning

Tuition Fee Payable Year 1

Tuition Fee Payable Year 2 (if applicable)

Tuition Fee Payable Year 3 (if applicable)

Tuition Fee Payable Total

Signature ___________________________________

Date ___________________________________