Course Application - Bishop Auckland College

Applying for Certificate in the Principles of End of Life Care L2

Please fill out the form below to apply and we'll get in touch with you to discuss the admissions process.

Section 1/10

Personal Details

Please provide your full legal name, if you're application is accepted then this name will be used on any qualifications you may earn.

Title

First Name

Middle Names

Surname

Known As

Sex

Date of Birth

National Insurance Number

Check this box if you have studied with us previously

Previous Student Number (if known)

Name when last at College (if changed)

Section 2/10

Contact Information

Please ensure your email address is entered correctly and that you check your emails regularly. We will contact you regarding your application and the scheduling of any interviews at the address provided.

Email Address

Telephone

Mobile Phone

Section 3/10

Home Address*

Post Code Search

Cannot find your address? Enter your address manually.

Address Line 1

Address Line 2

City/Town

County

Post Code

Approximately when did you begin living at this address?

Section 4/10

Emergency Contacts

Primary Contact

Contacts First Name

Contacts Surname

Contacts Phone Number

Relationship to Contact

Contacts Email Address

Secondary Contact

Contacts First Name

Contacts Surname

Contacts Phone Number

Relationship to Contact

Section 5/10

Background

Please select your ethnic group:

Please select your nationality:

Check this box if you have been a UK or European resident for the past 3 or more years

If you did not check the above, please give your date of entry into UK or EU

Check this box if you have any unspent criminal convictions

Section 6/10

Education

If you are 19 or under please select the last school you attended (if listed):

Have you had any extra time or other concessions in Exams? (Max 255 Characters)

Check this box if you have passed GCSE Maths

Check this box if you have passed GCSE English

Section 7/10

Qualifications

Please include any qualifications you are expecting to achieve before you start along with your predicted grades and the approximate dates you will achieve them.

Section 8/10

Medical Information

Select any of the below disabilities, health problems or special requirements that apply to you:

Please enter any additional disabilities, health problems or special requirements (Max 500 Characters)

Section 9/10

Additional Information

How did you hear about us?

What interests you about this course? (Max 255 Characters)

Section 10/10

Declaration

I declare that to the best of my knowledge the information given above is correct and that if accepted, I agree to comply with the rules and regulations of Bishop Auckland College. I agree to Bishop Auckland College processing the information contained on this application form.

Please note that by completing this form your details will be held on the College database, in accordance with the Data Protection Act 2018, and will be used for administration purposes. As part of our Admissions process we will send you information and communications relating to your application and admissions. For further information on how we use, hold and retain your data please see our Privacy Notice - Students and Prospective Students