Application Form

Sixth Form Course Application

You are applying for AAQ in Health and Social Care

This course is aimed at school leavers aged 16–18.

This course is based at Selby College.

Additional Courses

Please choose two additional A Levels. You will study three A Levels overall as part of your programme.

Select two additional courses to study alongside AAQ in Health and Social Care: *

Your Details

Provide your legal name exactly as it appears on your birth certificate. Do not use nicknames or preferred names.

Title: *

Pronouns:

First Name: *

Surname: *

Preferred Name:

Any Previous Surname:

Date of Birth: *

Gender: *

Ethnicity: *

Are you a Young Adult Carer? *

Your Contact Details

Please provide your email and phone numbers. Mobile number is required for SMS updates.

Mobile Number: *

Telephone:

Email Address: *

Your Address

Address Line 1: *

Address Line 2:

Town/City: *

County:

Postcode: *

Parent/Carer Information

Please give the name and telephone number of your parent, carer, or legal guardian who should be contacted in case of an emergency. They should be aware that the college may contact them during your scheduled course hours if needed.

Parent/Carer First Name: *

Parent/Carer Surname: *

Relationship to You: *

Parent/Carer Contact Number: *

Parent/Carer Email Address: *

Medical Needs

Please indicate if you have any medical needs we should be aware of.

Do you have a medical condition? *

Yes

Qualifications

Please add your predicted grades, we will not be able to process your application without these.

Qualifications/Predicted Grades: *

Qualification	Grade	Status	Date Awarded

What career are you interested in?

Citizenship

Country of Residence: *

Citizenship: *

Additional Information

Present School/Last Education Establishment: *

How did you hear about the College? *

For any admissions enquiries relating to your application or enrolment, our Admissions Team is here to help. Whether you need guidance on completing your application, understanding entry requirements, or the enrolment process, please don’t hesitate to get in touch.

You can contact the team by email at admissions@heartofyorkshire.ac.uk or call 01924 789110, and a member of staff will be happy to assist you.

Visit our How to Apply page to find out more about our application process.