BTEC Foundation Diploma in Art, Application for entry to Queen Elizabeth Sixth Form College in Darlington - 2024/25 Foundation Diploma in Art, Design & Media Practice Step 1 of 6 16% Student's Personal DetailsPlease enter your surname, forenames, date of birth and sex exactly as they are stated on official documents, such as your birth certificate or passport.Forename(s)* Surname* Preferred Name* Do not include surnameSex*MaleFemaleDate of Birth* Day Month Year (dd/mm/yyyy)Present/Most Recent School*Please select...Acklam Grange SchoolAll Saints C of E, Ingleby BarwickBarnard CastleBeaumont Hill AcademyBedaleBede Sixth Form SRCBishop BarringtonBishopsgarth, Stockton on TeesCarmelConyers SchoolDarlington CollegeDurham HighDurham JohnstonDurham SchoolEgglescliffeEnglish Martyrs, HartlepoolFerryhillGrangefieldHaughton AcademyHermitage, Stockton on TeesHigh Tunstall, HartlepoolHome EducatedHummersknottHurworthIan RamseyIngleby Manor Free SchoolKing James ILongfieldMacmillan AcademyNorthallerton CollegeNorthfield, BillinghamOur Lady & St. Bede RCOutwood Academy AcklamParksidePolam HallQueen Elizabeth Sixth FormQueen Ethelburga's CollegiateQueen Mary's, ThirskRed HouseRichmondRipon GrammarRisedaleSedgefieldSpennymoorSt. Aidan'sSt. Francis XavierSt. Johns (Bishop Auckland)St Leonard's Catholic SchoolSt. Michael's RC, BillinghamSt Patrick's Catholic CollegeStaindropStockton Riverside CollegeStokesley SchoolTeesdaleTeesside HighThe Oaks Secondary SchoolThirsk School and Sixth Form CollegeTrinity Catholic CollegeTudhoe GrangeUnknownUTC South DurhamWensleydaleWhitworth ParkWolsinghamWoodhamWyvern AcademyYarmOtherCurrent courses being studiedSchool (if other)* Student Mobile Student Email Have you lived in the UK for the past 3 years?* Yes No Is English your first language?* Yes No You have selected 'other' as your language, please enter your language here* Home Address* City/Town* CountyCounty DurhamNorth YorkshireTeessideClevelandYorkshireOtherCounty (if other chosen) Postcode* Parent / Carer Title*MrMrsMissMsDrParent / Carer Surname* (including title - for correspondence, e.g. Mr Smith)Home Telephone Number This should be a house phoneParent /Carer's Mobile Number* Please enter 000 if you don't have a parental mobile numberParent / Carer's Email Address Are there any learning difficulties / physical disabilities / medical conditions we should be aware of?NoYesLearning Difficulties Moderate learning difficulty Severe learning difficulty Dyslexia Dyscalculia Other specific learning difficulty Autism spectrum disorder Multiple learning difficulties Other You can select more than one options in the above list if this is relevantPhysical / Medical Difficulties Visual impairment Hearing impairment Disability affecting mobility Other physical disability Other medical condition (i.e. epilepsy, asthma ...) Emotional/behavioural difficulties Mental health difficulty Temporary disability after illness or accident Profound complex disabilities Aspergers syndrome Multiple disabilities Other You can select more than one options in the above list if this is relevantSo that we can provide appropriate additional support, please give relevant additional information hereEthnic Origin* English/Welsh/Scottish/Northern Irish/British Irish Gypsy or Irish Traveller Any other White background White and Black Caribbean White and Black African White and Asian Any other mixed/multiple ethnic background Indian Pakistani Bangladeshi Chinese Any other Asian background African Caribbean Any other Black/African/Caribbean background Arab Any other ethnic group Not provided Please select one (for monitoring purposes only) Examination Results eg: GCSEs, A Levels, AS Levels, BTEC, OCR National, NVQSubjectLevelGradeDate Posts held in full or part time employment, or relevant work experience:Please give names and addresses - with telephone numbers, if possible - of two referees we may contact: One reference should be from your current or most recent school or college.Referee 1:Referee 2: Please give additional information in support of your application e.g. why you wish to continue your Art & Design education, what interests or hobbies you pursue, what posts of responsibility you have held and which career you hope to follow in the future. Almost finished...Please read the statement below and don't forget to hit Send How We Use Your Personal Information This privacy notice is issued by the Education and Skills Funding Agency (ESFA), on behalf of the Secretary of State for the Department of Education (DfE). It is to inform learners how their personal information will be used by the DfE, the ESFA (an executive agency of the DfE) and any successor bodies to these organisations. For the purposes of relevant data protection legislation, the DfE is the data controller for personal data processed by the ESFA. Your personal information is used by the DfE to exercise its functions and to meet its statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009 and to create and maintain a unique learner number (ULN) and a personal learning record (PLR). Your information will be securely destroyed after it is no longer required for these purposes. Your information may be used for education, training, employment and well-being related purposes, including for research. The DfE and the English European Social Fund (ESF) Managing Authority (or agents acting on their behalf) may contact you in order for them to carry out research and evaluation to inform the effectiveness of training. Your information may also be shared with other third parties for the above purposes, but only where the law allows it and the sharing is in compliance with data protection legislation.Tick these boxes if you DO NOT wish to be contacted: About courses or learning opportunities For surveys and research Tick any of these boxes if you DO NOT wish to be contacted: By post By phone By email Further information about use of and access to your personal data, and details of organisations with whom we regularly share data are available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/611954/Appendix_F_ILR_2017__to_2018_v1_Published_28April17.pdf All organisations that will have access to the information you provide are registered under the Data Protection Act 1998. At no time will your personal information be passed to organisations for marketing or sales purposes. I understand that my data will be disclosed to appropriate government organisations and that I may be contacted by the College or by these organisations. Δ
