SECTION 1 - PERSONAL DETAILS

Title *

• Mr
• Mrs
• Miss
• Ms
• Dr
• Other

Name *

First

Middle

Last

Gender *

• Male
• Female
• Prefer Not to say

Date of Birth *

Nationality *

Country of Birth *

N.I. Number *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountry

Name *

First

Last

Email *

Relationship *

Emergency Contact Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Province of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountry

SECTION 2 - COURSE DETAILS

Courses *

• Functional Skills English
• Functional Skills Maths
• Functional Skills ICT
• Traineeship Customer services 16-24
• Business Management Level 3
• Hospitality Level 3
• First Aid
• University Admission
• HNC/HND Business (2 years)
• HNC/HND Healthcare Practice (2 years)
• DET (1 year)
• BA (Top-up) BM (1 year)
• Foundation Degree BMS (4 years)
• BA (Hons) BMS (3 years)
• Other

Intake

Month *JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember

Year *

SECTION 3 - PREVIOUS QUALIFICATIONS

Please provide details of your academic qualifications (highest first)

Qualification 1

Name of Institution

Date of Award

Place of study

Grade

Qualification 2

Name of Institution

Date of Award

Place of study

Grade

SECTION 4 - WORK EXPERIENCE

Job Title/Nature of work (If applicable)

Name and location of organisation

From

To

Job Title/Nature of work

Name and location of organisation

From

To

SECTION 5 - ETHNIC BACKGROUND

White / Asian / Mixed / Multiple Ethnic Group Black / African / Caribbean / Black British Other

• English / Welsh / Scottish / Northern Irish / British (31)
• Irish (32)
• Gypsy or Irish Traveller (33)
• Any other white background
• Indian (39)
• Pakistani (40)
• Bangladesh (41)
• Chinese (42)
• Any other Asian background (43)
• White and Black Caribbean (35)
• White and Black African (36)
• White and Asian (37)
• Any other Mixed / Multiple ethnic background (38)
• African (44)
• Caribbean (45)
• Caribbean / Background (46)
• Arab (47)
• Any other ethnic group (98)

SECTION 6 – LEARNING DIFFICULITIES AND DISIABILITIES

Do you consider yourself to have a learning difficulty or disability? *

• Yes
• No

Do you consider that you may need additional support whilst attending? *

• Yes
• No

SECTION 7 – CRIMINAL CONVICTIONS

To help the College reduce the risks of harm or injury to students caused by the criminal behaviour of other students, we must know about any relevant criminal convictions an applicant has. Relevant criminal convictions for offences against a person, whether of a violent or sexual nature, and convictions for offences involving unlawfully supplying controlled drugs or substances where the conviction concerns commercial drug dealing or trafficking.

Do you have any criminal convictions? *YesNo

SECTION 8 – SLC ELIGIBILITY CHECK

Have you studied in any other College/University prior to enrolling at EduTrain 360, where your course was funded by Student Finance England? * *YesNo

SECTION 9 – REFFERED BY

HOW DID YOU HEAR ABOUT US?

Select One *

• Family/Friend
• Advertisement
• Web
• Other

Please provide further details, e.g. name of your referee: *

File Upload

Click or drag a file to this area to upload.

SECTION 10 – DECLARATIONS

The information you provide on this application form will only be used to contact you regarding your request ubless you give your consent by checking the box below. Expect where required by law, we only share it with our staff and college. The information is stored for 6 months from the date of your request or unsubscribed from marketing information.

By ticking the boxes below, you also indicate your consent for us to send you the following marketing information. *

• I consent to Fixth School of Business using my contact details to periodically send me information about learning opportunities and special offers available from I consent to Fixth School of Business.
• I do not wish to be contacted with additional marketing information and do not consent to my contact details begin retained by I consent to Fixth School of Business.

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