Student Application Form

Please make sure you have all information to hand before completing this form. You will need to provide the following information, if applicable:
- Next of kin details
- Date you were registered blind or visually impaired
- Details of your education and qualifications (from aged 11)
- Details of employment and/or training
- Name and address of a referee (e.g. headteacher or previous employer)
- Details of your EHCP Co-ordinator, QTVI, Social Worker and Disability Employment Adviser

If there is a question not relevant to your circumstances, please note down 'N/A' in the corresponding response box. All fields on the form are required to be completed before submitting your application.


Section 1: Personal Details













Next of Kin details








Please help us monitor equality and diversity by ticking the appropriate box * Required


Please indicate your religion/belief * Required


Section 2: Your Disability






Have you and do you see any of the following? * Required


Section 3: Course Information


Section 4: Education History and Qualifications Achieved




Do you have an Education Health and Care Plan? * Required


Section 5: Employment History (if applicable)



Section 6: Stakeholder - please indicate relevant adviser(s) details
Local Authority EHCP Co-ordinator





QTVI





Social Worker





Disability Employment Advisor





Section 7: Mobility Information







Section 8: Preferred Working Medium
How do you access information? * Required


Do you use a PC? * Required


Section 9: Other Information About You



Section 10: Marketing Information
Where did you hear about RNC? Please tick appropriate option and give further details if possible. * Required


Section 11: Disclosure of Criminal Convictions (to be completed by all applicants)
Safeguarding for all at The Royal National College for the Blind is given paramount importance. As you are applying for a placement where you may study with vulnerable young people and adults it is RNC policy to ask you to disclose any convictions or cautions you may have. Furthermore, as part of your programme you may be required to provide details to the Disclosure and Barring Service. Failure to disclose past convictions or cautions may result in termination of programme. Have you ever been convicted of a criminal offence or received a caution, reprimand or warning? If yes, you will be contacted by designated staff to provide further information. * Required

Section 12: Data Protection and Declaration/Consent
Please note that by completing this form your details will be held on our student record system and will be used for the purpose of administration, guidance and monitoring to assist you with your education whilst at RNC. As part of our admissions process we will send you information and communications relating to your application and admissions (by email, text, post or phone). RNC will occasionally make student information available to external agencies (e.g. examination boards, careers service, results publications, government agencies, prospective employers, etc). We will also share your information with your current school and any other nominated support worker or representative you may be working with to help you through our application process. The details you have provided may also be shared with internal / external support staff to ensure appropriate support is provided. The data you supply may also be used to check for, or obtain, a unique learner number.

RNC is committed to equal opportunities. See our Equality Policy on the College website for more details. We may contact any recent education provider to request information. By is committed to equal opportunities. See our Equality Policy on the College website for more details. We may contact any recent education provider to request information. By ticking the box below you agree that your personal information can be processed and used in this way.

I confirm I have read the RNC terms and conditions. * Required