Loan and Full Cost Application Form

Course Details

Course*

Select a course

Do you have a career route in mind? If so, please share this with us:

If you have a career route in mind, please enter it

Your Details

Title*

Please select your title

First Name*

Please enter your first name

Last Name*

Please enter your last name

Date of Birth*

Please enter your date of birth

Gender*

Please select your gender

Your Employer Details

Employer name*

Please enter your employers name

Contact name*

Please enter a contact name for your employer

Contact number*

Please enter a contact number for your employer contact

Contact email*

Please enter an email address for your employer contact

Your Contact Details

Address*

Please enter your full address

Street Address Address Line 2 Town / City County Postcode Country

Telephone*

Please enter your telephone number

Mobile*

Please enter your mobile phone number

Personal Email Address*

Please enter your personal email address

Qualifications

Last Place of Study*

Please enter your last place of study

From (Year Only)*

Please enter the year that you started at your last place of study

To (Year Only)*

Please enter the year that you finished at your last place of study

Qualifications*

Please enter all qualifications you have achieved during your studies. Please use the plus button to add more qualifications.

Subject and Level	Predicted Grade	Please state if you achieved this: at school/home education OR after school leaving age in further education / 6th Form

Please tick this box if you are currently home educated.

Nationality

Nationality*

Please enter your nationality.

Country of Residence*

Please select your country of residence.

Have you been living in the United Kingdom for the past 3 years?*

Please select if you have been living in United Kingdom for the past 3 years.

Yes
No

Please state previous country of residence (if applicable).

Please enter your previous country of residence.

Please note: You will need to bring to interview your Passport and any other identification upon request.

Support Needs

We provide a range of support for students with disabilities and support needs. To ensure that we can provide you with any additional support you need during the application process, at interview and beyond, if you have a disability and/or support need, please tick the relevant boxes below as appropriate:

Support Needs

Please select all of the support needs you require.

If you have ticked any of the above, we will contact you shortly to discuss further support needs.

Are you currently in care or a care leaver?*

Please select if you are currently in care or are a care leaver.

Yes
No

Do you have any convictions which are not yet spent under the Rehabilitation of Offenders Act 1974 (as amended)?*

Please select if you have any convictions which are not yet spent under the Rehabilitation of Offenders Act 1974. For further advice regarding unspent convictions contact NACRO at www.nacro.org.uk

Yes
No

Please record contact details of your key worker or support worker if you have one.

If you have a key worker or support worker, select enter their contact details.

Do you require any alternative arrangements or additional support to assist you at your interview?*

Please select if you require any alternative arrangement or additional support at your interview.

Yes
No

We would like to talk to you about your support needs at interview; you may bring someone to support you if you wish.

Where did you hear about us?

Tick all that apply.

Please select where you heard about us. Tick all that apply.

Declaration by Applicant

East Coast College has produced a Privacy Notice for students which is in accordance with the GDPR and the Data Protection Act 2018.

The Privacy Notice is available on request and can be found on the College website at www.eastcoast.ac.uk/legal (opens in new tab).

If you have any questions about this notice or the ways in which we use your personal information, please contact our Data Protection Officer at St Peters Street Lowestoft, NR32 2NB or dataprotection@eastcoast.ac.uk

I certify that all the information provided is correct. I agree that admission as a student is subject to my acceptance of the colleges regulations.*

Loan and Full Cost Application Form

Course Application Form - Apprenticeships

Course Details

Your Details

Your Employer Details

Your Contact Details

Qualifications

Nationality

Support Needs

Where did you hear about us?

Declaration by Applicant