Student Application Form

Please confirm the academic year you're applying for.(Required)

September 2027

September 2028

Section 1 – Applicant Details

Name(Required)

First Last

Known as

Gender(Required)

Male

Female

Other

Pronoun

Date of Birth(Required)

Home Address(Required)

Street Address Town / City County / Region Postcode Country

Home Telephone Number

Applicant's Mobile Number

Applicant's Email Address

Ethnicity(Required)

Religion(Required)

Are you a permanent UK resident?(Required)

Yes

No

Do you have valid permission to reside in the UK?(Required)

Yes

No

Next of Kin's Name(Required)

First Last

Next of Kin's Home Phone Number (if different to applicant)

Next of Kin's Mobile Number(Required)

Next of Kin's Email Address(Required)

Next of Kin's Home Address(Required)

Same as applicant

Different to applicant

Next of Kin's Home Address(Required)

Street Address Town / City County / Region Postcode Country

Next of Kin's Relationship to Applicant(Required)

Section 4 – Stakeholder and Professional Contact

Please provide details of your primary SEN contact at your local authority.

Name of contact: Role or Job Title: Email Address: Telephone Number:

If you have a social worker, please provide their details.

Name of contact: Role or Job Title: Email Address: Telephone Number:

If you have a Qualified Teacher Vision Impairment (QTVI), please provide their details.

Name of contact: Role or Job Title: Email Address: Telephone Number:

Section 5 – Additional information

Please confirm your preferred working medium.(Required)

Standard print (12pt)

Large print

Contracted (grade 2) braille

Uncontracted (grade 1) braille

Audio

Other

Please specify print size and format, e.g. Arial 18pt bold.(Required)

Please specify what your working medium is.(Required)

Please provide details of any IT equipment and assistive technology or specialist software you use.(Required)

If there is any additional information you would like to provide us with?

Have you ever been convicted of a criminal offence or received a caution, reprimand or warning? If yes, you will be contacted by a designated member of RNC Safeguarding Team to provide further information?(Required)

Yes

No

Section 7 – Privacy Notice, Data Protection and Personal Information

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, result publications, government agencies, prospective employers etc.). We may 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 (ULN). RNC is committed to equal opportunities, our Equality Policy can be found on our website.

I consent to RNC contacting my current or most recent school or college, Local Authority SEND services, Social Services, and QTVI to support the assessment of my needs and to request supporting documentation for my application.(Required)

I agree

Signed (potential learner)(Required)

Signed (parent/carer if learner is under 18)

Date(Required)