Application form - Aquinas College

ADULT CENTREHOW TO APPLY:If you have decided to apply for the Access to Higher Education Diploma, the next steps are:STEP 1:Download and complete an Application Form.You can apply from 14 January 2013 onwards.Please ensure you fully complete all sections of the form, as your application is considered on the information given.STEP 2:Once completed post or email your application form to:Sheila Lahan (Mrs), Adult Centre ManagerAquinas CollegeNangreave RoadStockport, Cheshire SK2 6THsheila@aquinas.ac.ukAcknowledgement of your applicationWe will send you an acknowledgement within 5 days of receipt of your application. If you have not heard from us within tendays, please contact our Adult Centre Helpline (0161 419 9163) or email: sheila@aquinas.ac.ukInterview and/or our decision about your applicationYour application will be processed by the relevant curriculum department and you may be invited to attend an interview.At the interview you will be asked to complete an Initial Assessment for literacy and numeracy which will help us to place you onthe correct course and identify any possible support needs that you might have. Also, you will need to demonstrate to thecourse tutor/advisor that you have the commitment and skills necessary to successfully complete the course.You will be asked to bring to your interview any certificates for qualifications you have listed on your application form.All applicants will be sent a letter about the outcome of their application.If you are not sure which subjects you wish to study, and you wish to speak to someone before you complete thisform, please telephone 0161 419 9163 to arrange an appointment.

ADULT CENTREPlease Note:You must be 19 years old or over on the9 th September 2013 and not in full timeeducation to apply for this course.Application Form 2013-14Access to Higher Education Diploma(Health & Social Science or Humanities and Social Science)Equal Opportunities StatementAquinas College Adult Centre is committed toPromoting and supporting learning for each individualEquality of opportunityNon-discriminatory practicesAquinas College welcomes learners to the college regardless of the racial, ethnic or national origin, age, disabilityor sexuality.We aim to ensure that all students at Aquinas College receive a high standard of education and service since westrive to put into practice the Gospel spirit of freedom, justice and love which is at the very heart of our philosophy.PLEASE NOTE: The Award of the Access to Higher Education Diploma does not guarantee entry into University.PLEASE COMPLETE IN BLOCK CAPITALS (handwritten or word processed accepted)PERSONAL DETAILS:Title:Mr/Mrs/Miss/Ms/Other (please state) __________Surname:First Name (s): Gender: Male Female Date of Birth:Home address:Home telephone NoWork telephone NoMobile telephone NoPostcodeE-mail address:UK Status:Have you been living in the UK/EEA for the last 3 years? Yes No

PROGRAMME OF STUDY:Subject choice:(Please tick box)Health Science & PsychologyLaw/Criminology & PsychologyUnsure – to be discussed at interviewPREFERREDHealth Pathway: GCSE English, Maths & Science at C or aboveENTRY REQUIREMENTS: Law Pathway: GCSE English & Maths at C or aboveADDITIONAL SUPPORT:The college wants to support students in as many ways as possible. Please give details of any health/physical conditionsthat may require special arrangements (wheelchair access, specific learning needs etc.).Are there any areas that you might need help/support with? (e.g. spelling, writing, fractions. percentages):Yes (please state what): __________________________________________________________________________No EDUCATIONAL BACKGROUND:Please list the names and addresses of school/colleges attended. Start with the most recent:Date from Date to School/CollegePlease list examinations taken/qualifications achieved. Please include any distance or open learning courses. Startwith the most recent:AwardingBody e.g.City & GuildsEdexcelSubject(s)/ Course(s)Qualification, e.g.:O level, GCSE, As/ALevel, NVQ, AccessYear takenResults(grades ifpossible)

PAYING YOUR FEESAgegroupAge 19-23Age 24+You willhave topay yourown fees.Please tick in the end box which applies to youYou may be eligible for a free course if this is your first full A level OR level 3courseYou may be eligible for a free course if you are in receipt of Job SeekersAllowance or Employment Support Allowance (Work Activity Group).Pay your fees in full yourself in one lump sumPay your fees in full yourself, paying a deposit and the balance by standingorderYour choices are:Pay your fees in full yourself in one lump sumPay your fees in full yourself, paying a deposit and the balance by standingorderTake out a 24+ Advanced Learning Loan for the full amountPay part of the fee yourself and take out the balance using a 24+ AdvancedLearning LoanETHNICITY:Ethnic origin information is required as part of our monitoring of the College’s Equal Opportunities PolicyPlease tick the most appropriate box :White – British (23) Black African - Mixed – white (20)White – Irish (24) Black Caribbean - Mixed – white (21)White – other White background (25) Black or Black British – African (15)Asian or Asian British – Bangladeshi (11) Black or Black British – Caribbean (16)Asian or Asian British – Indian (12)Black or Black British – other Black background(17)Asian or Asian British – (13) Chinese (18)Asian or Asian British – other AsianMixed – other mixed background (22)background (14)Asian - Mixed – white (19)Other (98)– please specify:__________________Prefer not to sayMARKETING:How did you hear about Aquinas College Adult Centre? (Please tick) The Review Leaflet Local Library National Careers Service Internet search Other College/educational provider Word of mouth Other, please specify: ________________________Preferred interview times, please tick:PM – between 4 and 5.30 pm Evening – between 6 pm and 7.30 pm

EDUCATIONAL/CAREER AIMS:On a single sheet of A4, (using a separate sheet if necessary), and using a minimum of 300words:DESCRIBE:1. Why you are applying for this course:2. Your career background/voluntary work you are or have been involved in:3. Aims for the future, i.e. are you intending to apply for University, or is thereanother pathway you have in mind:

PLEASE NOTE HERE ANYTHING YOU FEEL MAY BE RELEVANT WHICH HAS NOT BEEN REQUESTEDALREADY:DECLARATION:I CERTIFY THAT THE DETAILS GIVEN IN THIS APPLICATION ARE CORRECT.Signature Name (PRINT) DatePlease return your completed Application Form to:Sheila Lahan (Mrs), Adult Centre ManagerAquinas CollegeNangreave RoadStockport, Cheshire SK2 6THThis section for office use only:DATEAPPLICATIONFORMRECEIVED:INTERVIEWDATEINITIALASSESSMENTCARRIED OUT(DATE)RESULT OFINITIALASSESSMENTDATE OFOFFERLETTERACCEPTANCERECEIVEDLiteracyNumeracy