Skills Academy Form

School
& Pupil
Information

Student's
Details

Course
Selection

Additional
Support

Safeguarding

Last Page

School & pupil information

Name of School *

School Contact Name *

School Email address

Confederation/Cluster

School telephone number *

Preferred start date *

Please fill in the missing information before proceeding.

Student's details

Student's Surname *

Student's First Name *

Student's Address *

Student's Town/City *

Student's Postcode *

Student's Phone Number

Student's Email Address

School Year in September 2022 *

Student's Date of Birth *

UPN

ULN

How would you describe your ethnic origin?

Emergency Contact Details

Emergency Contact Name *

Emergency Contact Address *

Emergency Contact Town/City *

Emergency Contact Postcode *

Emergency Contact Email *

Emergency Contact Number *

Relationship to Student *

Please fill in the missing information before proceeding.

Additional Support

The College will support students who have Special Educational Needs (SEN), disabilities or learning difficulties, medical or health conditions or mental ill health. * Please note: if this is one to one support, your school may be asked to provide the same support to this student while they are in college.

Does the student have an EHCP or do they receive High Needs funding? (If yes, please forward a copy of their EHCP / latest review documentation) *

Does the student have any Exam Access Arrangements? (If yes, please forward any supporting evidence to the College) *

Does the student have Special Educational Needs (SEN), disabilities or learning difficulties, medical or health conditions or mental ill health? *

Does the student have SEN Support? *

Is the student considered to be ‘Child Looked After’? *

Is the student eligible for Free School Meals? *

Does the student have an allergy which you would like us to know about? *

Please specify

Please fill in the missing information before proceeding.

Safeguarding

Does the young person have a current Safeguarding issue? *

Does the young person have a Criminal Conviction(s) or are they currently under Police investigation? *

Does the young person have a Safeguarding Risk Assessment (or RAMP)? *

Please forward any relevant documents (for example EHCP, Risk Assessment) to craft@lcb.ac.uk

Please fill in the missing information before proceeding.

Declaration

When you complete, sign and submit this application form, you are expressly giving your permission for the College to process your data, including sensitive and personal information.

The information you supply will be used to enable us to meet the statutory and mandatory responsibilities outlined by the Government, including creating a unique learner number (ULN). When necessary, the information will be shared with the Education and Skills Funding Agency, the Department for Business, Innovation and Skills (BIS), local councils and your school or college.

You can read more about this in the Student Privacy Notice.

I confirm that my headteacher and school bursar are aware of the cost implications of the named student taking part in this programme, should their application be successful. *

I confirm that I've read our Skills Academy Letter to Schools, located on the 14-16 Skills Academy pages on our website. *

Signed on behalf of school: *

Skills Academy Form

For use by schools

School & pupil information

Student's details

Emergency Contact Details

Course Selection

Additional Support

Safeguarding

Declaration

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