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Adult Course Application Form

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Apply to Reaseheath College now...

Welcome to our Application Form. Please provide us with as much information as possible to support your application. Once we receive your form we will make contact with you to invite you to attend an informal interview (where applicable).

Please note that this application form is for adult NSF courses and adult Maths & English courses only.

For all other Adult Learning and Higher Education courses please visit the relevant sections on our website.
Course applying for
Course applying for*
Address and Contact Details
Name*
Title First name Middle name(s) Last name
Gender*
Date of birth*

Day
Month
Year
Current age*
Address*
Address line 1 Address line 2 City County Postcode Country
How many years have you lived at your current address?*
Mobile number*
Alternative contact number
Email address*
Enter Email Confirm Email

Nationality
Are you a British citizen?*
Nationality*
Have you been a resident in the UK/EU in the past 3 years*
Country of residence prior to the past 3 years*
How many years did you live at this address for?*

Support Needs
Have you previously had exam access arrangements?*
Do you have any learning difficulties or disabilities?*
Do you have an Education, Health and Care Plan (EHC Plan)?*

Education
Please select which of the following applies to you*
Do you hold a Level 3 qualification?*
E.g. A Level, Diploma, Technical Certificate
- Yes
- No
What is your highest qualification?*
Please give details of the qualification Level and Grade
Are you working towards or do you have any GCSE or equivalent qualifications?*
1. Maths Qualification*
Maths Level*
Maths GCSE Grade*
Maths Functional Skills Grade*
Maths O Level Grade*
Maths CSE Grade*
Maths 'Other' Grade*
Please give details of the qualification Level and Grade
Do you already have this qualification or are you working towards it?*
- Already have it
- Working towards it
- No qualification
2. English Qualification*
English Level*
English GCSE Grade*
English Functional Skills Grade*
English O Level Grade*
English CSE Grade*
English 'Other' Grade*
Please give details of the qualification Level and Grade
Do you already have this qualification or are you working towards it?*
- Already have it
- Working towards it
- No qualification
3. Science Qualification*
Science Level*
Science GCSE Grade*
Science Functional Skills Grade*
Science O Level Grade*
Science CSE Grade*
Science 'Other' Grade*
Please give details of the qualification Level and Grade
Do you already have this qualification or are you working towards it?*
- Already have it
- Working towards it
- No qualification

Prior experience
Personal Statement*
Please include details of previous experience, interests or any other relevant information in support of your application.
Referee details*
First name Last name Position
Referee address*
Address line 1 Address line 2 City County Post code Country
Referee telephone number*
Referee email*

Final Steps
Data protection*
Reaseheath College will store the information on this form and other information relating to you whilst attending college subject to the provisions of the General Data Protection Regulation (EU) 2016/679 (GDPR) and the Data Protection Act 2018. Read our privacy notice to find out more about how we use your personal information.
- I agree
I can confirm I am either over the age of 18 or under the age of 18 and have parental consent to apply for a course at Reaseheath College.*
- I agree
I understand that it is my responsibility to ensure that the information disclosed in this application is correct. I understand that disclosure of incorrect information may impact on my eligibility for funding and may result in my liability for fees or charge in relation to my programme of study.*
- I agree
Name
This field is for validation purposes and should be left unchanged.

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Reaseheath College
Nantwich
Cheshire, CW5 6DF

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enquiries@
reaseheath.ac.uk

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Further Education: 01270 613242
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