Please note: To secure your place at Selby College, please ensure your application is received by us as soon as possible. Where a course is filled, late applicants may not get their first choice of course. Application Form 1. Personal Details Please complete all fields unless they are marked as optional. About You What course(s) are you interested in? Show all courses A Level Art, Craft & Design A Level Art & Design (Photography) A Level Media Studies A Level Accounting A Level Business Studies A Level Law A Level Geography A Level History A Level Computer Science BTEC Level 3 Extended Certificate in Information Technology A Level French A Level Spanish A Level English Language A Level English Literature A Level Mathematics Level 3 Mathematics Certificate - Core Maths A Level Further Mathematics A Level Psychology A Level Biology A Level Chemistry A Level Physics A Level Sociology BTEC Level 3 Extended Certificate in Applied Sport Full Name Date of Birth Date of Birth must be in the format dd/mm/yyyy Unique Learner Number (Optional) My Gender Is: Female Male Transgender Prefer not to say Your Contact Details Email Address Mobile Number (Optional) We will contact you by text to confirm the successful submission of your application. Contact Number Your Address Postcode Parent/Guardian Contact Details Full Name Email Address Mobile Number Guardian's Address Postcode Continue to next section You must select at least once course of interest. 2. Your Exams & Results Current or Last School/College/Employer Subject Level Example: GCSE, A-Level, BTEC, GNVQ, RSA etc. Estimated or Actual Grade Date Add another exam result to application Subject Level Example: GCSE, A-Level, BTEC, GNVQ, RSA etc. Estimated or Actual Grade Date Add another exam result to application Subject Level Example: GCSE, A-Level, BTEC, GNVQ, RSA etc. Estimated or Actual Grade Date Add another exam result to application Subject Level Example: GCSE, A-Level, BTEC, GNVQ, RSA etc. Estimated or Actual Grade Date Add another exam result to application Subject Level Example: GCSE, A-Level, BTEC, GNVQ, RSA etc. Estimated or Actual Grade Date Add another exam result to application Subject Level Example: GCSE, A-Level, BTEC, GNVQ, RSA etc. Estimated or Actual Grade Date Add another exam result to application Subject Level Example: GCSE, A-Level, BTEC, GNVQ, RSA etc. Estimated or Actual Grade Date Add another exam result to application Subject Level Example: GCSE, A-Level, BTEC, GNVQ, RSA etc. Estimated or Actual Grade Date Add another exam result to application Subject Level Example: GCSE, A-Level, BTEC, GNVQ, RSA etc. Estimated or Actual Grade Date Add another exam result to application Subject Level Example: GCSE, A-Level, BTEC, GNVQ, RSA etc. Estimated or Actual Grade Date Continue to next section 3. Learning Difficulty / Disabilities The following information will not affect how we assess your application. Selby College wants to help all learners reach their full potential. Sharing any support you have previously had, relating to a particular disability or learning need, will help is to support you better. Have you previously received any extra help or support with a disability or learning need? No Yes Do you have a "Statement of Educational Needs" or EHC plan? No Yes Have you had a Section 139 form completed? No Yes Have you previously had any support during exams? No Yes Priority learning difficulty or disability If you are affected by learning difficulties or disability, please tick any that apply below. Sensory Visual Hearing Physical Profound complex disabilities Disability effecting mobility Wheelchair user Other disabilities Medical Condition Asthma Epilepsy Diabetes Profound Complex Multiple Disabilities Temporary Impairment Other Disabilities Mental Health Mental health difficulties Social and Emotional difficulties Learning Difficulties Dyslexia Dyscalculia Autism Spectrum Disorder Aspergers Syndrome Multiple learning difficulties Moderate learning difficulties Severe learning difficulties Temporary disability after illness (For example post-viral or accident) Other physical disability Other medial condition Other learning difficulties e.g. Dyspraxia Prefer not to say Please specify any other details here (Optional) Support arrangements (Optional) Please let us know of any arrangements you currently have so we can help support you better Name of support contact (Optional) Support contact telephone (Optional) Continue to next section 4. References All applicants must supply the contact details of a referee who you asked permission for us to contact if necessary. Please note: For those applying from school, this should be your Head Teacher, Head of Year or Head of Careers. Name of referee Relationship to you Referee address Needs Do you have any additional needs? (Optional) Submit your application If you have any difficulty in completing this form, please contact Student Services on 01757 211040 and we will be happy to assist you in your application. Privacy Personal data held by Selby College is subject to General Data Protection Regulation (GDPR). For information about your rights under GDPR you can see our Privacy Notice for Students at selby.ac.uk/privacy
