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Short Course (non-ESFA funded) Enrolment Form 2023/24

Security Classification: Protected (When Completed)

Personal Details

Student Ref:

Residency

Title:

Legal Sex:

Nationality

Legal Surname:

UK/Ireland resident for the last 3 years?

Legal Forename(s):

Employment Status (on the day before the course starts)

Preferred Name:

Status:

Previous Surname:

If Employed or Self-Employed:

DOB:

Age: (as at start of academic year)

For how many hours are you employed per week?

Vehicle Registration:

If Unemployed:

Contact Details

For how long have you been unemployed?

Home Address

Were you also in full-time education or training?

Address 1:

Support Needs

Address 2:

We wish to make our courses accessible to all students and the following information will help us to give you full support.

Town:

County:

The needs you have indicated are:

Country:

Postcode:

Previous Postcode:

Home Tel. No:

Mobile Tel. No:

Equality & Diversity

Email:

Cornwall College is committed to ensuring people can learn and work without discrimination, where fairness is promoted and everyone is equally valued. The below question assists us in meeting this aim. The information gathered here also assists us in meeting our statutory requirements with regard to collection and analysis of data.

Emergency Contact Details

Please notify your emergency contact that their details have been provided/recorded

Name:

You indicated the description which best matches your ethnic origin as:

Relationship:

Address:

Previous Study

The level which represents your highest level qualification before attending this course:

ID verification uploaded:

Postcode:

Home Tel. No:

Mobile Tel. No:

Email:

Course Information
Course Code	Course Title		Start Date	Fee

Payment Method
Payment of Tuition Fees
Purchase Order Number (if requested):
Employer Name:		Employer Email:

The Learning Agreement
I confirm that all the information given is correct. I have received assessment and guidance to assist in my choice of programme and I am satisfied that I fully understand the entry and programme requirements and will have the opportunity to receive advice about learning opportunities and any financial support available to me. I agree to observe The Cornwall College Group (TCCG) Values and to make myself familiar with and abide by the Learner Code of Conduct and any associated policies including the disciplinary procedure. I understand that if I declare false information TCCG may take action against me to reclaim the tuition fees and any support costs provided. I accept responsibility for the payment of any fees due and I understand that if I leave a course prematurely or fail to pay instalments on time, all fees outstanding, including any phased payments, will become due and payable on demand. I am aware that fees are non-refundable unless otherwise stated. I am aware of TCCG’s fees and charging policy and that the programme I am undertaking may be offered elsewhere at a different fee. I agree to pay for any loss or damage to TCCG property for which I am responsible and understand that non-payment may result in the withholding, by TCCG, of examination certificates, references, reports, etc., until full settlement has been made. I agree to work towards qualifications and submit assessments (where appropriate). I understand that if my programme is sponsored, my employer and/or training agent can be given details of my attendance and progress. I am aware that TCCG provides courses which are funded by the UK Government. (Learners aged under 18 only) – I agree that TCCG may contact, or respond to queries from, my parents/guardians over concerns relating to my academic performance, attendance, punctuality or behaviour. Where this poses a problem the onus is on me to discuss the situation with my tutor.
Your Information
For details on the processing of your data and our privacy notice please visit https://www.cornwall.ac.uk/governance/your-information/ TCCG is committed to protecting your personal information and is formally registered with the Information Commissioner’s office (our reg: Z6606742) The information provided on this form, together with information collected during your learning will be used for administration, research, future planning and health and safety purposes and may be shared with other organisations directly associated with funding, certification, support and guidance as well as with parents/guardians for students under 18. Information will also be used to provide references where requested in support of applications for employment or future study. TCCG may take photographs, video or otherwise record learner activities for assessment purposes. You may be contacted after you have completed your programme of learning to establish whether you have entered employment or gone onto further training or education. The Department for Education (or its agents acting on their behalf) may contact you to carry out research and evaluation to inform the effectiveness of training. The personal information you provide is submitted to the Department for Education (DfE), the Education & Skills Funding Agency (ESFA) an executive agency of the DfE, and any successor bodies to these organisations. Your personal information is used by the above to exercise its functions and to meet statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009, and to create, access and maintain a unique learner number (ULN) and a personal learning record (PLR). The information you provide may be shared with other organisations for education, research, training, employment and well-being related purposes. Further information about the DfE use of and access to your personal data, and details of organisations with whom they regularly share data, information about how long your data is retained and how to change your consent to being contacted are available at: https://www.gov.uk/government/publications/privacy-notice-for-key-stage-5-and-adult-education
You opted in to the following forms of contact:
Criminal Convictions
TCCG is committed to protecting our students and staff. To achieve this we need to know about you and any criminal convictions you have. If you do not tick either a ‘Yes’ or a ‘No’ box below we will contact you to get this information and this will delay your enrolment. You must declare a conviction unless it is a motoring offence for which you received a fine or three or fewer penalty points OR a spent sentence (as defined by the Rehabilitation of Offenders Act 1974). Please be aware that for certain courses, particularly in teaching, health and social care you must tell us about ANY criminal conviction(s) including spent sentences and cautions. If you are serving a prison sentence you must tick the "Yes" box. If you are convicted of a criminal offence after you have enrolled you MUST let us know immediately. If you are unsure whether to tell us about a previous conviction you should seek advice from your local Citizens Advice Bureau or speak to our Safeguarding Team.
Do you have any unspent criminal convictions?
Declaration: I confirm that I have read and agree to be bound by TCCG’s Terms & Conditions including those set out in the Learning Agreement, Privacy Notice and any documents associated with my programme to which my attention has been drawn.

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

Draw Signature
Type In Signature

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Adopt & Sign

Timestamp

Audit

10th April 2024 9:14 am BST

[NEW] Enrolment Type 5 Uploaded by TCCG Registry - registry@cornwall.ac.uk IP 10.1.92.43