Years 10 and 11 Application Form (Home Schooled)

Years 10 and 11 Application Form for Home Educated students

Please use this form to apply: IT MUST BE COMPLETED BY A PARENT/GUARDIAN

Personal Details
Name*
Prefix First Name Surname
Preferred Name (if applicable)
Name
Gender:
Nationality:*
Ethnicity*
Date of Birth*
DD slash MM slash YYYY
Current Age:*
Current Year Group*
Student Mobile Number:
Parent Information:
Name of Parent/Guardian*
Prefix First Last
Relationship to Student:*
Email of Parent/Guardian:*
Mobile Number of Parent/Guardian:*
Home Telephone Number of Parent/Guardian:
Full Address*
Postcode*
County*
Course Details
Which year are you applying for?*
Which course would you like to apply for?*
Career ambition (if known)
How did you hear about Brooklands College?*
Education
Name of school most recently attended:*
Year left school:*
Reason for leaving:*
Are you registered with the Local Authority as Home Educating?*
Please note that for funding purposes, the College requires that students must be registered with the Local Authority
Name of Local Authority:*
Local Authority Contact (if known):
Email:
Telephone:
Disabilities, medical conditions and learning support
Do you have a disability or medical condition?*
If yes, please provide brief details:
Do you require any specialist equipment?*
Do you have an EHCP?*
A copy must be submitted by the EHCP Caseworker with the application to EHCP@brooklands.ac.uk We will not be able to arrange an interview until we have checked that we are able to meet the needs of the EHCP
Have you received any support at secondary school?*
Are you eligible for Free School Meals?*
Are you in the care of the local authority or Leaving Care Team?*
Do you have parent/carer responsibilities?*
Are there any safeguarding concerns?*
Do you have a criminal record or had any involvement with the police?*
Other Agency Involvement i.e. social worker/CAMHS*
Are there any concerns regarding behaviour?*
Are there any concerns regarding attendance?*
Name of person completing the form:*
Relationship to student:*
Date*
DD slash MM slash YYYY

Brooklands Technical College
Weybridge Campus

Heath Road, Weybridge, Surrey KT13 8TT

Brooklands Technical College
Ashford Campus

Stanwell Road, Ashford TW15 3DU

Call

01932 797 700

info@brooklands.ac.uk

Years 10 and 11 Application Form (Home Schooled)

Years 10 and 11 Application Form for Home Educated students

Personal Details

Parent Information:

Course Details

Education

Disabilities, medical conditions and learning support