D
Existing Qualifications
Please identify the highest qualification you expect to have when starting the course (please tick appropriate box below): No qualifications Entry level: eg ESOL/literacy/numeracy entry 1 to entry 3 Level 1: eg NVQ L1, 4 GCSEs D-G, BTEC Introductory Diploma Level 2: eg 5 GCSEs grades A-C, BTEC First Diploma, NVQ L2, Higher Diploma
Level 3: eg 2+ A Levels, 4 AS Levels, BTEC National, NVQ L3, Advanced Diploma Level 4: eg HNC/HND, Foundation Degree/Degree, NVQ L4 Level 5+: Masters Degree, PhD, NVQ L5/6/7
Please list ALL qualifications completed or currently undertaking. (Please continue on a separate sheet.) (for example: title, module titles, awarding body, institution where qualification taken)
Do you have a GCSE in English at grades A*- C? Yes
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Date qualification completed (state year where exact date unknown)
Level achieved
Do you have a GCSE in Maths at grades A*- C? Yes
No
# If you have a GCSE English or Maths certificate, please enclose a photocopy with this application form.
DECLARATION I wish to apply for the following fee concession: Entry/level 1: I declare that I do not already have a full level 1 and that I am undertaking this course as a step towards undertaking either an Apprenticeship or alternative full level 2 course.
E
Support for Your Course
We offer a range of additional support to help you achieve to the best of your ability. Please tell us what support you may need. This information will be treated as confidential and will only be used to help us ensure you get the support you need on your course. Completing this section will not affect you getting onto a course. Please tick all the relevant boxes.
Do you need extra help to complete your course? Yes
Level 2/3: I declare that I do not already have a full level 2 or level 3 qualification. Level 2 Level 3
Learning Difficulties
Disabilities
I do not have a learning difficulty
I do not have a disability
Autism Spectrum Disorder
Aspergers syndrome
Dyscalculia
Asthma
Dyslexia
Diabetes
Dyspraxia
Disability affecting mobility
Moderate learning difficulty
Emotional/behaviour issues
Multiple learning difficulties
Epilepsy
Severe learning difficulty
Hearing impairment
Other - please state
ME Mental health issues
No
Multiple disabilities Profound complex disabilities Temporary disability after illness or accident
Do you have a medical condition that needs treatment? Yes
Visual impairment
No
Other - please state
Please state
01752 305026
employers@cityplym.ac.uk
www.cityplym.ac.uk/employers
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No