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Part-Time Application Form

Personal Details

(16 - 18 Students only)

Ethnicity and Residency

Education

Disabilities, Medical Conditions & Learning Support Details

Employment Status

Declaration of Criminal Convictions

As a duty of care to staff and students, the College reserves the right not to enrol a person where there is evidence that they could be a threat or danger to others. Declaring convictions may not prevent you from being offered a place but failure to disclose something of which we later become aware could result in disciplinary action or your enrolment being cancelled.

Course details

Please state which course(s) you wish to enrol on (including course codes if known)

Payment of Fees

Please complete one of the following sections, whichever is relevant to you. If section C applies, evidence must be provided at enrolment to confirm a fee concession

FEE DECLARATION

I am satisfied that the costs associated with the programme have been explained to me. If any proposed payment via a loan or employer is not fulfilled, or I withdraw, the liability for any unpaid fees will revert back to me. In the event that a debt collection agency is involved then I will be liable for tuition fees plus any legal and administrative fees incurred. I understand that refunds will only be issued in the event of the course being cancelled by the College or in exceptional circumstances in line with the College Refund Procedure (copy available on request).

Marketing Evaluation

Learning Agreement Declaration

I am satisfied that:

  • The suitability of the programme and the entry requirements for it have been explained to me.
  • I have received information, advice and guidance on my choice of learning programme and progression routes. (not applicable for Adult Community Learning and non-qualification courses)

Declaration:

  • I formally accept the learning programme specified on this agreement.
  • I certify that the information I have provided is complete and correct.
  • I agree to abide by the Learner Contract (available at www.esc.ac.uk or www.johnruskin.ac.uk).
  • I authorise the College to provide appropriate information to my parent(s) or guardian(s) (if under 19) or employer, sponsor or Student Loan Company (if appropriate) on progress and attendance on courses for which I have enrolled, or in the event of any cause for concern or a medical emergency.
  • I confirm that I have read the Enrolment Terms & Conditions (available at www.esc.ac.uk/enrolment-terms-conditions or www.johnruskin.ac.uk/about-jrc/policies-and-procedures).
  • I agree to be contacted by the College after the end of my course to establish destination data (including Apprenticeship progression) for use within the College reporting mechanisms.

Privacy Notice 2020/2021 | How We Use Your Personal Information

This privacy notice is issued by the Education and Skills Funding Agency (ESFA), on behalf of the Secretary of State for the Department of Education (DfE). It is to inform learners how their personal information will be used by the DfE, the ESFA (an executive agency of the DfE) and any successor bodies to these organisations.

For the purposes of relevant data protection legislation, the DfE is the data controller for personal data processed by the ESFA. Your personal information is used by the DfE to exercise its functions and to meet its statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009 and to create and maintain a unique learner number (ULN) and a personal learning record (PLR). Your information will be securely destroyed after it is no longer required for these purposes. Your information may be used for education, training, employment and well-being related purposes, including for research. The DfE and the English European Social Fund (ESF) Managing Authority (or agents acting on their behalf) may contact you in order for them to carry out research and evaluation to inform the effectiveness of training.

Your information may also be shared with other third parties for the above purposes, but only where the law allows it and the sharing is in compliance with data protection legislation.

Further information about use of and access to your personal data, details of organisations with whom we regularly share data, information about how long we retain your data, and how to change your consent to being contacted, please visit: www.gov.uk/government/publications/esfa-privacy-notice

Imagery

On occasion you may be photographed/filmed at an event, in your classroom or around the College. Your image, name and/or coursework may be used to celebrate student success or to promote courses and the work of the College.

Staying in Touch

Your privacy is important to us. We’d like to keep in touch so please complete your contact preferences below.

I confirm that I have read the Learning Agreement Declaration incorporating the Imagery and Staying In Touch sections.

Please click Submit to confirm the above statement.

You can withdraw your permission for the use of your personal data at any time by contacting Client Services. (If you would like a more detailed explanation about GDPR changes and your right to be forgotten visit https://ico.org.uk)

Address: John Ruskin College, Selsdon Park Road, South Croydon, CR2 8JJ

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