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Part Time Enrolment Form

Personal Details

Qualifications

Employment

Terms

Personal Details

Student Reference Number (if known) -
Surname
First Forename
Other Forenames
Known As
Title
Date Of Birth
Sex
Telephone
Mobile
Email Address

Nationality, Equality and Diversity

Ethnic Group
What is your country of residence
What is your first language?
Nationality

Have you always lived in England?

NOTE: Please upload UK ID when prompted

Have you lived in the UK for more than 3 years?

Is Home Fees

NOTE: Please upload UK ID when prompted

You may not be entitled to funding for this course - you will need to contact the college for further advice

Are you an Asylum Seeker ?

NOTE: Please upload your Asylum ID on the next stage of this form

Do you have settled status in the UK ?

Visa Type

If your visa isnt listed, please set your settled status to no

Do you have a legal right to reside in the UK ?

Fee Eligiblity

You may not be entitled to funding for this course, please contact the college for futher advice

Criminal Convictions

Middlesbrough College has a legal and moral duty to safeguard and promote the welfare of all children, young people and vulnerable adults. Therefore, you are required to disclose information relating to any criminal convictions as part of your enrolment at the College. Having a criminal record will not necessarily prevent you from studying at the College but will depend on the nature of the course and the circumstances and background of the offence.

You will need to declare if any of the following apply to you:

  1. You have any convictions that are not yet spent under the Rehabilitation of Offenders Act 1974
  2. You have any convictions, cautions, reprimands or final warnings which are spent but not protected as defined by the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (as amended in 2013) (For courses that involve working with children or vulnerable adults.)
  3. You have any pending prosecutions
Do any of these apply to you?

Main Address

Please enter your postcode or partial address below:

Search:

House No / Street
District
Town
County
Postcode
Years at address

Parent/Guardian/Emergency Contacts

Primary Contact

Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone number
Emergency Contact Email Address

Secondary Contact

Emergency Contact Name
Emergency Contact Relationship
Emergency Contact Phone number
Emergency Contact Email Address

Learner Support

Do you have any disabilities or learning difficulties?

Do any of the below questions apply to you? Tick for YES leave blank for NO

The College offers a range of support services for students and if you select any of the options below we will discuss confidentially any support you may require

Young carer?

You're a young carer if you're under 18 and help to look after a relative with a disability, illness, mental health condition, or drug or alcohol problem

Young parent?

You're a young parent if you are under 18 and are the legal parent/guardian of a child

Care leaver?

A care leaver is any adult who spent time in care as a child (i.e. under the age of 18). Such care could be in foster care, residential care (mainly children's homes), or other arrangements outside the immediate or extended family

Looked After?

Are you currently in care or have you recently left the care of the Local Authority

Do you have an Education Health & Care Plan?
Describe best your household situation

If you can't find the course you want, or you have a query about a course, enrolment or fees please call 01642 333333, or email courseinfo@mbro.ac.uk