Application Form

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Personal Details

Title: *

First Names: *

Surname: *

Date of Birth: *

Current Age: *

What is your current age?

Primary Telephone Number: *

Secondary (Mobile) Number:

Email Address:

Address: *

Post Code: *

Address of Parent / Guardian if you are under 18 years of age:

Post Code:

Have you previously applied to or attended Lincoln, Newark or Gainsborough College?: *

Yes

Student ID Number:

Courses Applied For

Year of Entry: *

1st Course Choice: *

Location: *

Course Type: *

2nd Course Choice:

Location:

Course Type:

Do you require more information or advice?: *

Yes

Are you applying for A-Levels?: *

Yes

What A Level subjects would you like to study?:

Location:

lincoln

newark

Education

Name of school/college attended: *

Address of School:

Qualifications: *

Please tell us about any Courses you are currently studying, as well as any completed qualifications you may have. Include the Subject , Level, Date and Grade (or predicted grade) where applicable.

Your Course Choice

Please give supporting information for why you wish to be considered for this programme.
Include details of relevant work experience, voluntary work, interests, hobbies and long term career plans.

Details: *

Employment

Have you ever been employed, self-employed or worked as a volunteer?: *

Yes

Most recent employer:

Employment Type:

Dates of Employment:

Job Details:

Other employer:

Employment Type:

Dates of Employment:

Job Details:

Guidance and learning support

Do you consider yourself to have a learning difficulty and/or disability or mental health problem?: *

Yes

Details:

Please give details so that assessment and support may be considered.

Lincoln College provides specialist advice and resources to improve access for students with learning difficulties and disabilities to curriculum areas, to study skills and to College services. Qualified and experienced staff deliver classroom support, 1:1 tuition, communications support and assessments. The College wishes to ensure that it complies with the requirements of theEquality Act 2010. If you are a disabled person, please ensure that we know what you need so that we can make all reasonable adjustments to help you succeed.

References

If you are still attending school, the College will approach your tutor direct to request a reference. If you have left school, you will need to provide two contacts who will act as referees.

Are you still attending school?: *

Yes

Referee Name:

Position:

Address:

Second Referee Name:

Position:

Address:

DATA PROTECTION ACT - Lincoln College may use and process personal data or information regarding you (whether obtained from you on this form or otherwise, or from another person) for the purposes of processing your application to become a student at Lincoln College. If your application is successful, the College may also process personal data in conjunction with the administration of your enrolment.

The College may also process sensitive personal data, (which includes information as to your physical or mental health or condition) your racial / ethnic origin, the commission or alleged commission of any offence by you, and any proceedings for an offence committed or alleged to have been committed by you (including the outcome or sentence in such proceedings) for the same purposes.

Lincoln College commits itself to the active promotion of Equal Opportunities and is concerned with combating unlawful discrimination of any kind. All computerised information may be used and disclosed only as described in the 1998 Data Protection Act.