To help us monitor our Equal Opportunities Policies.Please place an X in the relevant boxes and complete details below NOTES
How would you describe your Ethnic Origin? Please tick one box only
Asian or Asian British - Bangladeshi Black or Black British - African Mixed - White and Asian
Asian or Asian British - Indian Black or Black British - Caribbean Mixed - White and Black African
Asian or Asian British - Pakistani Black or Black British - Other Black Mixed - White and Black Caribbean
Asian or Asian British - Other Asian Mixed - Any Other Mixed Background
White - British Chinese Other
White - Irish
White - Any Other White Background
Learning Support
City College Coventry is committed to supporting all its learners. To help us achieve this please answer all the following questions
(tick boxes appropriate).This will not affect your chances of being offered a place at the College.
Have you any support needs due to:-
A physical disability? Yes No
A specific learning difficulty (eg dyslexia,dyspraxia,autistic spectrum) Yes No
A medical condition which may affect your studies (eg mental health issues,diabeties,asthma) Yes No
If you have answered YES to any of the above, a member of the Learner Support Team will contact you to discuss the help and support
you may require.
Further Information
In order to support your application,please give brief details of training, work experience, hobbies and interests.
Please explain briefly why you wish to join and what you hope to gain from this course (continue on a separate sheet if necessary,
putting your name in the top right hand corner and attach to application form).
Data Protection Statement
I agree to City College Coventry processing my personal data, including sensitive personal data which may include information about any
learning difficulties or disabilities contained either in this form or other data, which City College Coventry may obtain from me or other
people.City College Coventry may contact me by email or text message.I agree to the processing of such data for any purposes connected
with my course application, my studies, my health and safety, or for any other legitimate reason.
Signed (Applicant):
Date:
Signed (Parent/Guardian If under 18):
This application form does not automatically guarantee you a course place.You will be advised of the next stage of the application process byAdmissions.
Thank you for applying to us. We will contact you as soon as possible regarding your application.
Return your application form to:
Central Admissions,City College Coventry,FREEPOST CV2838,COVENTRY,CV1 3BR
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