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Course Title : Introduction to Teaching and Supporting Learning
Course Dates : 6 July 2020 to 8 July 2020

Personal Details

Title Mr Mrs Ms
Firstname
Last Name
Date of Birth (dd/mm/yyyy)
Please be ware you must be 19 years or over to apply. Gender M F

Address

No & Street
Local Area
Town
County
Postcode

Contact Details

Telephone
Email

Emergency Contact

Name
Telephone

Equality & Diversity

The College monitors details of students as part of its commitment to equal opportunities. Please tick the boxes below which apply to you.
Please Choose Any other ethnic group Arab Asian or Asian British - any other Asian background Asian or Asian British - Bangladeshi Asian or Asian British - Chinese Asian or Asian British - Indian Asian or Asian British - Pakistani Black or Black British - African Black or Black British - any other Black/African/Caribbean background Black or Black British - Caribbean Mixed - any other Mixed background Mixed – White and Asian Mixed - White and Black African Mixed - White and Black Caribbean Prefer not to say White - any other White background White – English/Welsh/Scottish/N. Irish/British White – Gypsy or Irish Traveller White - Irish

Education & Employment History

Highest Qualification
Employment Status Employed - Full Time Employed - Part Time Self Employed Unwaged - Not Seeking Work Retired Unemployed - Seeking Work

Are you unemployed and in receipt of JSA or ESA (WRAG)? Yes No

Local Education Authority

LEA (ie. Where you pay your tax)

Requirements

We provide additional learning support, technology and appropriate dedicated accommodation for learners with a disability or serious medical condition, a learning difficulty or mental health issues, who qualify for it. Please declare below and bring evidence of your Personal Independence Payment or a medical note when you attend for your course. This information will be treated as confidential.

Would you like to declare a need? Yes No
Are you staying overnight at the college? Yes No

Dietary Requirements

Do you have any special dietary requirements? Yes No

Children

For those unable to make their own childcare arrangements, we provide a limited number of places for children aged over 6 months and upto 11 years and 11 months.
Please note children will share rooms with parents, and there is no guarantee of a childcare place being offered. Places will not be allocated for your children unless all details are supplied.

Please give details of any disability, registered or unregistered, or medical condition, of which you think the Children's Centre should be aware:

Additional Information

Have you previously studied at Northern College? Yes No

Where did you hear about Northern College? Newspaper I am a Former Student Careers Guidance/Library Word of Mouth Referred by another college Employer Community Centre/Group Northern College Leaflet Found on Web Other

Comments?

Learning Needs

Please spend a few minutes completing this questionnaire. It will help us to plan the course. We want to make sure that, as far as possible, we have taken all your educational needs into account. If you would like advice, help or support to complete this, please phone the Northern College Registry on 01226 776010, they will put you in touch with the course tutor.

• Have you been on other courses recently (in the past 12 months) outside Northern College?
  If you have, please give brief details.
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• What do you hope to get out of the course? What are your main reasons for applying to come?
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• Our courses often involve discussing ideas with other students, you may be asked to take notes about your discussions. Some courses will involve reading short passages (not aloud!) or doing short pieces of writing.
  Please let us know if you may need some help in doing this.
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• Is there anything else you would like us to know before you come on the course?
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Thankyou for taking time to complete this questionnaire.
This will enable us to make your visit and learning experience as welcoming as possible