Higher Education Part Time Application

Form for all higher education part-time courses at Barnsley College.

Course Title*
Course Title
You can apply for one additional course from the list below.
Do you want to apply for another course?
- Yes
Name*
First Last
Date of birth*
Address*
Number and Street Address Line 2 Town/City County Post Code
Do you have a different address for correspondence?
- No
- Yes
Correspondence Address
Address Town/City County Post Code
Your email address*
Daytime telephone number:*
Mobile telephone number:
Country of birth*
This is the country you were born in
Nationality*
This is the country for which you are entitled to hold a passport
Have you lived in the UK or EU for more than 3 years?*
- Yes
- No
Date that you came to live in the UK or EU
Date Format: DD slash MM slash YYYY
Residential Status*
- British / EU Citizen
- Asylum Seeker
- Refugee
Gender*
What gender do you identify with?
Your ethnicity -
This information is strictly confidential and will not be used to identify you personally.

Name of previous school/college or training provider you attended
Date Started
Date Finished
Qualifications*
Please list all the relevant qualifications you have achieved or are currently working towards, including grades.
How will your tuition fees be paid?
- Student Loans Company
- Employer
- Paying your own fees
Employer name and address*
Street Address Address Line 2 Town/City Post Code
Contact person
Email
Telephone number*
Learner support*
Do you consider yourself to have a learning difficulty and/or disability including access need and/or health problem? We will work with you to ensure you have all the individual help you need to do well at University Campus Barnsley.
- Yes
- No

PERSONAL STATEMENT*
Please explain why you have chosen this course, how your previous education and experience have prepared you for the course and your future career plans.
Referee 1 - Name*
First Last
Position*
Organisation name and address*
Street Address Address Line 2 Town/City Post Code
Email
Telephone number
Referee 2 - Name
First Last
Position
Organisation name and address
Street Address Address Line 2 Town/City Post Code
Email
Telephone number
Phone
This field is for validation purposes and should be left unchanged.

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