Course applicationform

Course Details

Please state the title of the course you wish to apply for - NC CREATIVE INDUSTRIES ONLINE

Month and Year of Entry–April 2016

Mode of Attendance -Part Time/Online

Year of Course - 1st

Why have you applied for this course? ______

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Personal Details

Title (Ms/Miss/Mr/Other)______

First Name______

Surname______Previous Surname (if applicable)______

Address ______

______

Postcode______

Home Telephone Number______

Mobile Telephone Number______

Email Address______(this email will be used to communicate with you)

Education

Please give the name and address of the last educational establishment you attended.

______

Please specified last course studied______

Month/Year Started______

Month/Year Finished______

Student Number (if known______

SQA Number (if known) ______

Qualifications

Subject / Level / Awarding Body / Result / Year / Grade

Please note that we will require proof of any qualifications included.

References

Please give the contact details of someone who would be willing to provide a reference e.g. an employer or teacher but not family members or friends.

Name of referee______

Occupation of referee & relationship to you ______

Address______

______

Telephone Number______

Email Address______

Equal Opportunities

Inverness College is committed to creating and maintaining a college environment that is open, welcoming and positive and in which everyone is valuedand supported. Please be assured that the information provided in this section will not influence your application in any way, it will help us to deliver the course in a format that suits your needs and allows us to monitor that our Equality and Diversity Policy is effective.Please mark yes or no, or highlight as appropriate, if you do not wish to provide any information please choose “Prefer not to say”.

A - No known Disability

B - A social/communication impairment such as Asperger’s Syndrome or other autistic spectrum disorder

C - Blind or have a serious visual impairment

D - Deaf or have a serious hearing impairment

E - Along standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease or epilepsy

F- Mental health condition such as depression, schizophrenia or anxiety disorder

G - A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D

H - A physical impairment or mobility issue

J - Two or more impairments and/or disabling medical conditions

I - A disability, impairment or medical condition not listed

R - Prefer not to say

P - Personal Care Support

Meeting your needs

Inverness College is committed to meeting the needs of all our students. Information gathered in this section is not used in the selection process. Please let us know if you consider yourself to have additional support needs and if so please specify.

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Data Protection

Inverness College UHI is committed to ensuring the processing of personal data is only undertaken in the legitimate operation of the college's business. The college collects and uses information (data) about its students and stores it in accordance with the Data Protection Act 1998.

By providing us with your personal data and by signing below, you provide your explicit consent to us processing the said data for the purposes of your educational/training programme.

We will only provide such information to third parties where we are obliged to do so by law: for statistical reporting (e.g. ScottishFunding Council); to awarding bodies for certification purposes; and to employers and sponsoring bodies who pay student fees.

Personal Statement

Please complete the personal statement on the final page before signing dating and returning this application.

Applicant declaration

By signing this form, I confirm that, to the best of my knowledge the information given is correct and accurate.

Signature______

Date______

Please return to

Eleanor Adam

Development Officer– Highlands and Islands

Scottish Union Learning in the Highlands and Islands

UNISON Building

53 Shore Street

Inverness

IV1 1NF

Email:

Personal Statement

Please tell us why you decided to choose this course and a little about yourself. This should include your current or previous employment, work experience, hobbies, what have you been doing most recently and how you intend to use this qualifications to further your career.