1. Personal Details

Title: Mr/Mrs/Miss/Ms …...... ……..Date of Birth: …………………………………….…

Full name: ...... National Insurance No: ......

Address: ...... Nationality: ......

...... Sex: Male Female

......

County: ……………………….. Postcode: ......

Tel No: ...... …...... Mobile: ...... …......

Email: ......

Emergency Contact Details:

Name of Next of Kin / Guardian: ..………………………………………………………………………………………….

Address: if different from above......

  1. Apprenticeship Details

Please tick the BOX to indicate the Apprenticeship you are applying for:

AgricultureAnimal Care Active Leisure and Learning

RetailHorticulturePlumbing

(Amenity Hort/Sports Turf)

ButcheryEnvironmental ConservationGamekeeping

Forestry/ArboricultureEquineCustomer Service

Business and Administration

How did you hear about us?…………………………………………… Availability to start date: ………………….

  1. Additional Support for Learning and/or Disability

Do you have any kind of learning difficulty or disability which could affect your apprenticeship? Eg, physical disability, hearing or visual impairment, dyslexia or health problem.

I have a learning difficulty: Yes: No:I have a disability: Yes:No:

If ‘yes’, please provide details: ……………………………………………………………………………………………..

so that we can plan and secure appropriate support for you.

or tick the box if you would like someone to contact you to discuss your needs.

  1. Transport

Do you hold a driving licence? FULL M/CYCLE PROVISIONAL NO

Do you have your own transport? YES NO Date of licence if applicable: ......

  1. Career ambitions, hobbies and interests

......

…......

  1. Eligibility

Have you completed Year 11 at school?

If no, do you intend to return to full-time education after the summer vacation?

Are you attending a full-time college or university course?

Have you graduated or do you hold a Degree

Have you been a permanent resident in the UK or EU for the last 3 years?

If no please give the date of entry into the UK: …………………………

If no, are you an asylum seeker?

  1. Qualifications

Last school attended: ......

Last college attended: ......

Date of leaving/expected end date: ......

Please give details of the qualifications you have taken or due to take, from GCSE onwards – include any

Qualifications that may be relevant to your career aspirations. (Please continue on a separate sheet if necessary)

Subject / Date taken/
due to be taken / Level / Actual or predicted Grades
  1. Work Experience

Please give details of any work experience or jobs you have had, including part-time and/or voluntary work. (Please continue on a separate sheet if necessary)

Position (Please indicate whether this was work experience or paid employment) / Company / From / To

Signed: ...... Date: …......

  1. Data Protection

The information you provide on this application form will be retained by Kingston Maurward College for reference. It will not be made available to any third party organisations except those who have direct involvement with the facilities of college courses.

Last updated 08.04.11 / S Bishop