Submit your application Given Name(s) Family Name NI Number Age at present Home Telephone Date of Birth Mobile Number Email Address Home Address Previous Post Code (if lived at current address for less than 3yrs) Sex Sex MaleFemale Home Postcode Do you consider yourself to have a long-term learning difficulty, health problem or any learning difficulty? Do you consider yourself to have a long-term learning difficulty, health problem or any learning difficulty? yes no Do you have a section 139A Learning Difficulty Assessment or Education Health Care Plan? (LDA) Do you have a section 139A Learning Difficulty Assessment or Education Health Care Plan? (LDA) yes no If you have a learning difficulty or health problem, please you confirm what kind? If you have a learning difficulty or health problem, please you confirm what kind? Visual impairment (4) Hearing impairment (5) Disability affecting mobility (6) Profound complex disabilities (7) Social and emotional difficulties (8) Mental health difficulty (9) Moderate learning difficulty (10) Severe learning difficulty (11) Dyslexia (12) Dyscalculia (13) Autism spectrum disorder (14) Asperger’s syndrome (15) Temporary disability after illness or accident (16) Speech, Language and Communication needs (17) Other learning difficulty (96) Other physical disability (93) Other specific learning difficulty (e.g Dyspraxia) (94) Other medical condition (e.g epilepsy, asthma, diabetes) (95) Ethnicity EthnicityWhite - English, Welsh, Scottish, Northern Irish or British (31)White - Irish (32)White - Gypsy or Irish Traveller (33)White - Gypsy or Irish Traveller (33)White - Any other white background (34)Mixed/ Multiple ethnic group - White and Black Caribbean (35)Mixed/ Multiple ethnic group - White and Black African (36)Mixed/ Multiple ethnic group - White and Asian (37)Mixed/ Multiple ethnic group - Any other mixed / multiple ethnic background (38)Asian/ Asian British - Indian (39)Asian/ Asian British - Pakistani (40)Asian/ Asian British - Bangladeshi (41)Asian/ Asian British - Chinese (42)Asian/ Asian British - Any other Asian background (43)Black/ African/ Caribbean/ Black British - African (44)Black/ African/ Caribbean/ Black British - Caribbean (45)Black/ African/ Caribbean/ Black British - Any other Black / African / Caribbean background (46)Black/ African/ Caribbean/ Black British - Arab (47)Black/ African/ Caribbean/ Black British - Any other ethnic group (98) Are you currently enrolled with any other College or Training Provider? Are you currently enrolled with any other College or Training Provider? yes no What is your highest level of Qualification? What is your highest level of Qualification?GCSEAlevelBSC DegreeMasters Degree Previous Level 2 Vocational Qualification Previous Level 2 Vocational QualificationYesNo Previous Level 3 Vocational Qualification Previous Level 3 Vocational QualificationYesNo Where did you hear about us? Where did you hear about us?From a friendFlyerBL WebsiteNASSocial MediaSalon ReferalCareer EventsSchool ReferalsFind an Apprenticeship Gov Website 1st Course Choice 1st Course ChoiceSUMMER ACADEMYTRAINEESHIPLEVEL 2 HAIRDRESSINGLEVEL 3 HAIRDRESSINGLEVEL 2 BARBERING PROFESSIONALCERTIFICATE IN ASSESSING VOCATIONAL ACHIEVEMENTLEVEL 3 CERTIFICATE IN ARTIFICIAL NAIL STRUCTURESCITY & GUILDS LEVEL 4 DIPLOMA IN ADVANCED TECHNIQUES AND MANAGEMENT PRACTICE IN HAIRDRESSINGCITY & GUILDS LEVEL 4 DIPLOMA IN ADVANCED HAIRDRESSING TECHNIQUESBEAUTY 2nd Course Choice 2nd Course ChoiceSUMMER ACADEMYTRAINEESHIPLEVEL 2 HAIRDRESSINGLEVEL 3 HAIRDRESSINGLEVEL 2 BARBERING PROFESSIONALCERTIFICATE IN ASSESSING VOCATIONAL ACHIEVEMENTLEVEL 3 CERTIFICATE IN ARTIFICIAL NAIL STRUCTURESCITY & GUILDS LEVEL 4 DIPLOMA IN ADVANCED TECHNIQUES AND MANAGEMENT PRACTICE IN HAIRDRESSINGCITY & GUILDS LEVEL 4 DIPLOMA IN ADVANCED HAIRDRESSING TECHNIQUESBEAUTY 14 + 10 = Submit