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Higher Education Enrolment Form

Personal Details

Qualifications

Employment

Terms



Personal Details


Surname
First Forename
Title
Date Of Birth
Legal Gender
Do you Identify as Transgender?
Telephone
Mobile
Personal Email

Main Address

Home Address
Address Line 2
Town
County
Number of years at current address

Vehicle Details

Plumpton has onsite parking available to students who live over 2 miles from College. If you require a car park pass, please complete the following

Car Colour
Car Make
Car Model
Car Reg

Nationality

Nationality
What is your Ethnicity
What is your country of Residence
Will you have lived continuously in the UK or EU for more than 3 years on the first day of your course?
 
Visa Type
Date of Entry into the UK (If non UK or EU resident)
What country did you arrive from?
Visa Expiry Date

Alternative Term Time Address

If you are living away from home during your studies, please provide the details of your Term Time address below

Accomodation Type:
House number / Street name
Area
Town/City
County

Please select which address to use for correspondence:


Emergency Contact

Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone number
Emergency Contact Email Address

Learner Support

Do you have any disabilities or learning difficulties?
 

Are you any of the following?

In care?
Young carer?
Young parent?
Care leaver?
Do you have an Education Health & Care Plan?
Are you eligible for Free school meals?
Describe best your household situation

If you can't find the course you want, or you have a query about a course, enrolment or payment please call 01273 890 454

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