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Direct Enrolment Form

Personal Details


Title
First Forename
Middle Name(s)
Surname
What would you like us to call you?
Legal Sex - hover for more info

Date of Birth

National Insurance No.
Unique Learner Number
Mobile

Tick for YES - leave blank for NO

Email Address

Tick for YES - leave blank for NO

Nationality
Ethnicity
What is your country of residence?
What is your first language?
Will you have lived continuously in the UK for more than 3 years on the first day of your course?

If you have not been a resident of the EU/UK/EEA for 3 years you may not be entitled to funding - we will need to collect more information from you to determine your eligbility

Visa Type
Date of Entry into the UK (If non UK or EU resident)
Visa Expiry Date

Address


House number and street name
Area
Town/City
County/District
Years at this address

Tick for YES - leave blank for NO


Is your term time address different to your home address?

Term Time Address

If you are living away from home during your studies, please provide the details of your Term Time address below

House number / Street name
Area
Town/City
County

Previous Qualifications:

What is your highest level of Qualification?

Use the following table to help you pick the correct qualification level...

LevelAcademic Qualification Equivalent
Entry Level first certificate GCSE - grades 3, 2, 1 or grades D, E, F, G level 1 award level 1 certificate level 1 diploma level 1 ESOL level 1 essential skills level 1 functional skills level 1 national vocational qualification (NVQ) music grades 1, 2 and 3
Level 1 For example, GCSE grades 1-3/F-D, First certificate, Level 1 Award/Certificate/Diploma, Functional Skill Level 1
Full Level 2 GCSE/O Level (5 or more GCSEs grades A*-C), GCSE (9-1) (5 or more GCSEs grade 4 or above), 2 or 3 AS Levels (for AS qualifications regulated before 1 September 2015), CSE Grade 1 (5 or more), 1 A Level, Higher 14-19 Diploma, QCF Diploma level 2, QCF Certificate level 2 at 13 or 14 credits undertaken before 2014 to 2015, Level 2 Principal Learning, NVQ level 2, GNVQ Intermediate,
Full Level 3 A Levels (2 or more advanced level passes), 4 or more AS Levels (for AS qualifications regulated before 1 September 2015), QCF Diploma Level 3, QAA Access to HE, Advanced 14-19 Diploma, GNVQ Advanced, NVQ level 3, AVCE double award, Tech Levels which are in the 16-19 Performance Tables, Applied Generals which are in the 16-19 Performance Tables (from 1 August 2015), QCF Certificate at Level 3 which is 30 to 36 credits
Level 4 For example, Certificate of Higher Education, Higher Apprenticeship, HNC
Level 5 For example, Diploma of Higher Education, Foundation Degree, HND
Level 6 For example, Degree Apprenticeship, Honours Degree
Level 7 For example, Masters level degree, PgDip
Level 8 For example, Doctorate/PhD

Tick for YES - leave blank for NO

Please tell us your previous school
What was the name of the place you last attended for education?
What grade have you achieved in GCSE English? 
What grade have you achieved in GCSE Maths? 

Emergency Contact / Next of Kin / Parent / Guardian

Primary Contact

Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone number
Emergency Contact Email Address

Tick for YES - leave blank for NO


Support & Safeguarding


Do you have any disabilities or learning difficulties?
Primary Disability/Learning Difficulty
Secondary Disability/Learning Difficulty

Please provide any extra information that can help us to help you

Notes

8000 characters left

Do you have any criminal convictions or are you currently under Police investigation?

You only have to disclose convictions where these are not spent under the Rehabilitation of Offenders Act 1974. A conviction becomes spent after any period of sentence has been completed. A prison sentence of four years or more will never be spent. If you are applying for a course which will involve working with children (under 18) or vulnerable adults then you will have to declare all convictions including cautions and reprimands. These activities are exempt from the Rehabilitation of Offenders Act 1974 Any failure to disclose criminal convictions may result in you being removed from your course.

You're a young carer if you're under 18 and help to look after a relative with a disability, illness, mental health condition, or drug or alcohol problem

You're a young parent if you are under 18 and are the legal parent/guardian of a child

Please tick if you are a Local Authority Looked After Child (16-18), Recent Care Leaver (18-25), unaccompanied asylum seeker or previously care experienced(e.g. in foster care, supported lodgings, residential care, special guardianship, in receipt of leaving care services or adopted)

Free school meals are provided by maintained schools, academies and free schools to all pupils who are in receipt of, or whose parents are in receipt of, one or more of the following benefits: • Universal Credit (provided you have an annual net earned income of no more than £7,400, as assessed by earnings from up to three of your most recent assessment periods) • Income Support • Income-based Jobseeker’s Allowance • Income-related Employment and Support Allowance • Support under Part VI of the Immigration and Asylum Act 1999 • The guarantee element of Pension Credit • Child Tax Credit (provided you’re not also entitled to Working Tax Credit and have an annual gross income of no more than £16,190) • Working Tax Credit run-on – paid for four weeks after you stop qualifying for Working Tax Credit

Do you have an Education Health & Care Plan?
Would you like to speak to a member of staff regarding Learning Support?
Have you or anyone in your household received a letter from the hospital or a GP to say they were on the 'shielded patients list'?
Are you caring for someone who is or was on the 'shielded patients list'?
Describe best your household situation
If another applies to you, please select

Please tick if you are a Local Authority Looked After Child (16-18), Recent Care Leaver (18-25), unaccompanied asylum seeker or previously care experienced(e.g. in foster care, supported lodgings, residential care, special guardianship, in receipt of leaving care services or adopted)


Employment

Employment Status
Are you self Employed?

How many hours per week? (If employed)
For how long have you been employed? (If employed)

Employer Details

Please enter the name of your current employer

Employer Name

Employer Address

Address Line 1 (Number and Street/Road)
Address Line 2 (Area)
Address Line 3 (Town/City)
Address Line 4 (County/District)
Employer Email
Employer Contact Number
Length of Unemployment (If Unemployed)

Choose your type of benefits, if none apply please leave blank

Benefit Status

Evidence

Please upload 1 form of Identification

Accepted forms of Identification:

  1. Current signed passport
  2. Original birth certificate (UK birth certificate issued within 12 months of the date of birth in full form including those issued by UK authorities overseas such as Embassies High Commissions and HM Forces)
  3. Current UK photocard driving licence
  4. Full old-style driving licence
  5. Residence permit issued by the Home Office to EEA nationals on sight of own country passport
  6. National identity card bearing a photograph of the applicant
Type of Evidence
Notes
Upload File


Terms & Privacy

How We Use Your Personal Information

The personal information you provide is passed to the chief executive of skills funding (the skills funding agency) and the department for business, innovation and skills(BIS). Where necessary it is also shared with the department for education, including education funding agency. The information is used for the exercise of functions of these government departments and to meet statutory responsibilities, including under the Apprenticeships, skills, children and learning act 2009, and to create and maintain a unique learner number (UNL) and a personal learning record (PLR).
The information you provide may be shared with other organisations for education, training, employment and wellbeing related purposes, including for research. Further information about the use of and access to your personal data, and details of organisations with whom we regularly share data are available here
If the course is government funded either through the EFA or the agency, it could also be eligible for match funding and can therefore be partially funded by the ESF. I consent to Inspire Education Group and the partner (where applicable) processing and using the personal and sensitive data set out in this form (the data) and any other stats which Inspire Education Group and the partner (where applicable) may obtain form me or other people about me for the purpose stated on this form or connected with my studies or any other legitimate reason
Inspire Education Group will contact you (and named parents/guardians for students aged 16 to 18-years-old) via email and text in relation to the progress of your application, events you need to attend as part of the application and enrolment process and information about Inspire Education Group on the lawful basis of legitimate interest in accordance with the General Data Protection Regulation 2018. The information submitted is processed by Inspire Education Group on the lawful basis of legal obligation, public task and legitimate interest in accordance with the General Data Protection Regulation 2018. For information on how long we hold your personal data, your rights of access and deletion of personal data click here or a copy can be requested here from the Digital Engagement Team.

Marketing & Research

Please tick all those below that you agree to be contacted about