1. PERSONAL DETAILS
Title
Mr
Mrs
Miss
Ms
First Name(s)
Last Name
Address
Date of Birth
Town
Post Code
Gender
Male
Female
Home Telephone
Telephone
Parent Name
Parent Telephone
Email Address
Have you been an EU resident for the last 3 years?
Yes
No
Nationality
Do you have any additional learning needs and/or disabilities?
Yes
No
Burnley College Sports Academies (A Levels and Full-Time only):
If you are a full-time student, and already play sport at a high level, you have the opportunity to join one of our Sport Academies. Please indicate if you are interested in becoming a member and you will be given further details at interview:
Basketball
Football
Golf
Netball
Rugby
Honours Programme (A Levels only):
If you would like to develop skills which will prepare you for challenging university level courses, please indicate and you will be given further details at interview