Permanent home address

Correspondence address (if different)

Are you disabled or have any existing Medical Problems? Yes No

If yes, please provide details:

Yes No

If yes, please provide further details:

Please provide the following information:

• Degree/A Levels/GCSEs/other
• Date passed
• University/College/School
• Address
• Award/Grade

Use the following space to provide any other information that we should consider when deciding your application.

Please select one of the following:

Diploma in Legal Studies

A/ AS Level Law

Health & Social Care

BTEC Health & Social Care

Access to Nursing

A/ AS Level Health & Social Care

Social Sciences

Diploma in Psychology

A/ AS Level Psychology

A/ AS Level Sociology

Languages

IELTS / IELTS/ TOEFL

GCSE's

French/ Spanish

Other Subjects and Short Courses

ESOL Skills for life with Numeracy ICT)/ British Citizenship Test

Law Tuition

Performing Art and Drama

Certificate in Performance Skills (NCFE Level 1 & 2)

Please note that as a general rule we will require the following documents:

• Proof of education/qualifications
• Two passport sized colour photographs

1. Students must abide by all academic, administrative and examination rules and regulations and policies of the College. All courses and term dates are subject to change. The College manual is available to all students in which contains details of college rules and regulations. The College reserves the right Not to undertake a course if the permitted number of studenst fall below a permitted level.
2. The College reserves the right to use your personal information in order to carry out its responsibilities in your personal and/or academic interests as a student of the College. The scope of usage of this information may include the publishing of good examination results, the award of a prize or scholarship, any achievement, academic or otherwise, and the access to your information by the Central Birmingham College's Alumni Association.
2a All courses are free - however, the College reserves the right to charge a concessionary fee for example to those that are employed. Refunds are made in two circumstances 1. Where the College is at fault - This means for example where a course does not begin. 2. The student or learner informs the College prior to the course start date that they cannot attend on medical grounds (medical certification required) Under No circumstances are fees refunded where a student starts the course and then withdraws. An administrative charge becomes applicable in all cases.
3. For progression, the following applies: The completion of a Pre-University/Diploma/Foundation Programme at Central Birmingham College does not give the student automatic admission to a University. Admission is determined by the student's performance and the University's entry requirements.
4. The terms and conditions stated in the paper application form shall take precedence
5. This agreement is governed by English law and you hereby submit to the exclusive jurisdiction of an independent arbitrator should any dispute arise.

Please type your name in the following space this will constitute your signature.