School Leavers Step 1 of 4 25% Personal Details *Denotes information that must be provided.Email*First Name*Family Name*Title*MrMrsMissOtherGender*MaleFemaleDate of Birth*DDMMYYYYPlease enter your date of birth in the format dd/mm/yyyyNationality*House Name / Number*Street*City / Town*County*Postcode*Country*Home Telephone*Work TelephoneMobile Additional Information *Denotes information that must be provided.Disability or Health Problems?*YesNoIf yes, please indicateDo you have a learning difficulty?*YesNoDo you need any support for your Disability, Health Problem or Learning Difficulty?*YesNo Course Selection *Denotes information that must be provided.Course / A-level subjects*Please enter the title of the course or A-level subjects you would like to apply for.Location*Bede Sixth FormSt Peter's Sixth FormUsworth Sixth FormHylton CampusShiney RowHeadways Sixth FormPredicted GCSE Results*An average GCSE result of A or BFive GCSEs between grades C and ATwo GCSEs at grade D or aboveOtherN/AName of Current School* Current Status *Denotes information that must be provided.Career AmbitionsHobbies Data Protection I accept that the information provided will be processed with the terms of the Data Protection Act 1998. From time to time, City of Sunderland College may approach you to take part in surveys and research as well as to provide you with information about courses or learning opportunities that we feel may be of interest to you. You may receive this type of information by post, telephone, SMS message or email.Data Protection opt outPostTelephoneEmailText MessagePlease tick the boxes of the methods you would not like us to contact you viaDeclarationI confirm to the best of my knowledge that the information given on this application form is correct and complete