Application for Further Education Courses

Application for Further Education Courses

To be returned to: Admissions Department, Leeds College of Music, 3 Quarry Hill, Leeds LS2 7PD

Please read the guidance notes in each section before completing the form

Please write clearly and in black ink

Year of entry / Please tick one course only per application form
Unless you have exceptional circumstances your application should be to one of the 2 year courses
2 Year BTEC Level 3 Extended Diploma in Music (Please tick one genre box) Classical Popular Music Jazz
2 YearBTEC Level 3 Extended Diploma in Music Technology
Or for applicants with exceptional circumstances* only (*please see website for information)
1 YearBTEC Level 3 90-Credit Diploma in Music (Please tick one genre box) Classical Popular Music Jazz
1 YearBTEC Level 3 90-Credit Diploma in Music Technology
Personal Details
1.Title: / 3.Forename(s):
2.Surname: / 4.Known as:
5.Date of birth: / 6.Age on 31st August: / 7a.National insurance number:
7b.Unique Learner number:
You can get this from your school
8a.What is your Nationality? / 9.What is your Principal instrument?
Please state precisely eg. Classical or Electric Guitar, Drum Kit or Percussion or Voice
8b. In which country have you been living for the three years prior to the start of the course (disregarding any temporary stay in the UK for educational purposes e.g. Boarding School)?
Address Details
10.Permanent Address:
Postcode:
Telephone: / Mobile:
Email:
11.Correspondence Address:
(if different from Permanent)
Postcode:
12.Emergency Contact Full name:
Relationship to you: / Telephone:
13.Parent/Guardian(if you are under 18):
Address (if different from above):
Postcode:
Relationship to you: / Telephone:
For official use only / ID number / Conditional / Unconditional
Ack / Refs requested? / Refs received / Unsuccessful / Alternative offer:
Musical experience and qualifications
14.How long have you studied your principal instrument?
15.Present music teachers full name:
Forename / Surname
16.Current Grade/Standard: If you have not obtained any recognised musical qualifications please give an indication of your current standard on your chosen instrument (including vocal) and theory:
Instrument grade/Standard:
Theory grade/Standard:
17.What other instruments do you play?
18.Music Qualifications attained:
Date taken / Examining Body / Title/Instrument & Grade of Exam / Result / Official use
19.Music Qualifications not yet completed:
Date to be taken / Examining Body / Title/Instrument & Grade of Exam / Official use
20.References: Please state the names, relationship to you and full addresses of two people who would be prepared to give you a reference (not friends or relatives). One of these should normally be from your most recent School/College. Other suitable referees might include instrumental tutor, music teacher, employer etc.
Referee 1 Full Name:
Relationship to you:
Address:
Postcode:
Email address:
Referee 2 Full Name:
Relationship to you:
Address:
Postcode:
Email address:
Education and Qualifications
21.Education from the age of 12:
School Name:
Address:
Postcode:
Year entered: / Year left:
School/College Name:
Address:
Postcode:
Year entered: / Year left:
22.Qualifications attained:(inc GCSEs, BTEC, NVQ, AS, A Level)
Examining Body / Full Subject title / Month & Year taken / Level
(eg, GCSE, BTEC, AS, A level, NVQ / Result/
Grade / Official use
23.Qualifications not yet completed:(inc GCSEs, BTEC, NVQ, AS, A Level)
Examining Body / Full Subject title / Month & Year to be taken / Level
(eg, GCSE, BTEC, AS, A level, NVQ / Predicted
Grade / Official use
24.Personal Statement: Please give further information about yourself and your music and/or music technology experience which may support your application
Explain why you wish to do this course and what you think it will lead to
Outline your previous musical or music technology experience both within education and in your own time
How do you plan to cope with the challenge of many written assignments and taking on more responsibility for your own learning?
What are you currently doing to improve and broaden your musical/music technology knowledge and skills?
25.Equal Opportunities:–Do you have any disabilities, learning difficulties, health conditions and/or impairments?
Please tick the appropriate boxes below and complete the additional forms enclosed whether you have ticked Yes or No:
Learning Difficulty / Yes / No / Health Condition / Yes / No
Disability / Yes / No / Impairment / Yes / No
26.Declaration by Candidate:–Do you have a criminal conviction which is currently unspent or can never become spent? You must answer this question.
If you are unsure whether you need to declare a conviction, please visit
Yes / No / If you tick the ‘yes’ box, we will ask you, confidentially, for further details.
27.Declaration: I undertake, if admitted to the conservatoire, to comply with Leeds College of Music regulations, procedures and rules. The particulars entered above are, to the best of my knowledge, correct
Signature / Date
Signature of parent/guardian (if under 18 years of age):

Please return to: Admissions Department, Leeds College of Music, 3 Quarry Hill, Leeds LS2 7PD

Telephone 01132223513 Fax: 01132438798 Email: Web:

Leeds College of Music protects the personal data provided by its applicants and students in compliance with the 1998 Data Protection Act. This information will be used for conservatoire management and to meet the requirements for Statutory Returns.Leeds College of Music operates an equal opportunities policy.

Leeds College of Music Equality, Diversity and Inclusion Policy

Leeds College of Music is committed to providing equal educational opportunities for all, and offering equal rights to all individuals to develop and achieve their full potential by opposing discrimination against people on the grounds of race, colour, nationality, ethnic origin, gender, marital status, sexual orientation, age, disability, social class, religious, cultural or political beliefs or through any other unjustifiable cause.
In order to monitor our adherence to this policy in relation to disabilities, learning difficulties, health conditions and/or impairments it would therefore be very helpful if you could provide us with the following information. We stress that this information is anonymous and strictly confidential and is used solely for Equalities monitoring. It will not be linked in any way with your application for the course as it is separated from your application form on arrival.
Course applied for:
Gender: (Please tick as appropriate) / Male / Female
Age: / 16-25 / 26-35 / 36-55 / 56-65 / 66+
Learning difficulties, disabilities, health conditions and impairments
Do you consider yourself to have a learning difficulty, disability, health condition or impairment?
Yes / No
Please indicate which of the following categories accurately describe you: (tick as many options as apply)
04 Visual impairment
05 Hearing impairment
06 Disability affecting mobility
07 Profound complex disabilities
08 Social and emotional difficulties
09 Mental health difficulty
10 Moderate learning difficulty
11 Severe learning difficulty
12 Dyslexia
13 Discalculia
14 Autism spectrum disorder
15 Aspergers syndrome
16 Temporary disability after illness (for example post-viral) or accident
93 Other physical disability
94 Other specific learning difficulty (for example dyspraxia)
95 Other medical condition (for example epilepsy, asthma, diabetes)
96 Other learning difficulty
97 Other disability
98 Prefer not to say
If you have ticked more than one option above, please indicate which is: your Primary disability here

Leeds College of Music Equality, Diversity and Inclusion Policy

Leeds College of Music is committed to providing equal educational opportunities for all, and offering equal rights to all individuals to develop and achieve their full potential by opposing discrimination against people on the grounds of race, colour, nationality, ethnic origin, gender, marital status, sexual orientation, age, disability, social class, religious, cultural or political beliefs or through any other unjustifiable cause.
In order to monitor our adherence to this policy in relation to ethnicity it would therefore be very helpful if you could provide us with the following information. We stress that this information is anonymous and strictly confidential and is used solely for Equalitiesmonitoring. It will not be linked in any way with your application for the course as it is separated from your application form on arrival.
Course applied for:
Gender: (Please tick as appropriate) / Male / Female
Age: / 16-25 / 26-35 / 36-55 / 56-65 / 66+
Ethnic Group:
Please indicate the category which you feel most appropriately describes yourself:
White
31 English / Welsh / Scottish / Northern Irish / British
32 Irish
33 Gypsy or Irish Traveller
34 Any other White background
Mixed / multiple ethnic group
35 White and Black Caribbean
36 White and Black African
37 White and Asian
38 Any other Mixed / multiple ethnic background
Asian / Asian British
39 Indian
40 Pakistani
41 Bangladeshi
42 Chinese
43 Any other Asian background
Black / African / Caribbean / Black British
44 African
45 Caribbean
46 Any other Black / African / Caribbean background
Other ethnic group
47 Arab
98 Any other ethnic group
99 Information not provided