Style sheets must be enabled to view this page as it was intended.

South Staffordshire College Enrolment Form

Course NameStart DateEnd DateSite
Italian Conversation for Beginners (FC)10/03/202507/04/2025Lichfield Campus

Section 1: Personal Details (1 of 2)



Surname (Family Name)
First Forename
Date of Birth
Sex
Preferred ProNoun
Mobile
Contact Number (Home Telephone)
Email Address
Email Address (enter again)
     
How did you hear about us?


Section 1: Personal Details (2 of 2)


Please enter your postcode or partial address below:

Search:


Please Select your address from the list below


Property/Street
Locality
Town
County
Number of years at this address




Section 2: Next of Kin / Emergency Contacts

Please provide details of up to two contacts. Learners aged 18 or younger must provide the details of at least one parent/guardian.


Next of Kin / Emergency Contact Name
Next of Kin / Emergency Contact Relationship
Next of Kin / Emergency Contact Phone number
Next of Kin / Emergency Contact Email Address

Do you live with this person? ( Please Tick if Yes )

Do you want to add another contact?
Second Contact Name
Second Contact Relationship
Second Contact Phone number
Second Contact Email Address

Do you live with this person?



Section 3: Residency



Nationality
Ethnic Group
What is your country of residence?
What is your first language?

Have you been legally resident in the UK/EEA for at least the last 3 Years for a purpose other than education?

If you have not been a resident of the EU/UK/EEA for 3 years you may not be entitled to funding - we will need to collect more information from you to determine your eligbility

Date of Entry into the UK (If non UK or EU resident)




Section 4: Photo



Please upload a clear headshot, for iPhone users - make sure the photo is rotated the correct way round

You can drag and drop files here, or click 'choose file' to upload from your device

NOTE: only JPG, JPEG, PNG and GIF files are allowed, 4MB maximum

Marketing Preferences

We would like to send you targeted information about future courses and services which may be of interest to you. To opt in please Select below

Please Confirm how you wish to be contacted ( You can tick more than one )

By Telephone
By Post
By Email
By SMS (Text Message)


I consent for my photo to be used in photographs and / or video recordings to promote the college for outside of the college use eg adverts , websites and social media

Terms & Privacy


Privacy Notice - How We Use Your Personal Information

This privacy notice is issued by the Education and Skills Funding Agency (ESFA) on behalf of the Secretary of State for the Department of Education (DfE) to inform learners about the Individualised Learner Record (ILR) and how their personal information is used in the ILR. Your personal information is used by the DfE to exercise our functions under article 6(1)(e) of the UK GDPR and to meet our statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009. Our lawful basis for using your special category personal data is covered under Substantial Public Interest based in law (Article 9(2)(g)) of GDPR legislation. This processing is under Section 54 of the Further and Higher Education Act (1992).

The ILR collects data about learners and learning undertaken. Publicly funded colleges, training organisations, local authorities, and employers (FE providers) must collect and return the data to the ESFA each year under the terms of a funding agreement, contract or grant agreement. It helps ensure that public money distributed through the ESFA is being spent in line with government targets. It is also used for education, training, employment, and well-being purposes, including research.

We retain your ILR learner data for 20 years for operational purposes (e.g. to fund your learning and to publish official statistics). Your personal data is then retained in our research databases until you are aged 80 years so that it can be used for long-term research purposes. For more information about the ILR and the data collected, please see the ILR specification at https://www.gov.uk/government/collections/individualised-learner-record-ilr

ILR data is shared with third parties where it complies with DfE data sharing procedures and where the law allows it. The DfE and the English European Social Fund (ESF) Managing Authority (or agents acting on their behalf) may contact learners to carry out research and evaluation to inform the effectiveness of training.

For more information about how your personal data is used and your individual rights, please see the DfE Personal Information Charter https://www.gov.uk/government/organisations/department-for-education/about/personal-information-charter and the DfE Privacy Notice https://www.gov.uk/government/publications/privacy-notice-for-key-stage-5-and-adult-education

If you would like to get in touch with us or request a copy of the personal information DfE holds about you, you can contact the DfE in the following ways:

Using our online contact form https://form.education.gov.uk/service/Contact_the_Department_for_Education

By telephoning the DfE Helpline on 0370 000 2288

Or in writing to: Data Protection Officer, Department for Education (B2.28), 7 & 8 Wellington Place, Wellington Street, Leeds, LS1 4AW

If you are unhappy with how we have used your personal data, you can complain to the Information Commissioner’s Office (ICO) at: Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF. You can also call their helpline on 0303 123 1113 or visit https://www.ico.org.uk

If you are a resident of the West Midlands Combined Authority (WMCA), please refer to https://wmca.org.uk/policies


Data Protection Act 2018 and GDPR

The personal information you have provided will be used to help provide educational related services. The information may be disclosed to specific third parties, such as ESFA, WMCA and examination boards if relevant. The information you supply is used by the Learning Records Service (LRS). The LRS issues Unique Learner Numbers (ULN) and creates Personal Learning records across England, Wales and Northern Ireland, and is operated by the Education and Skills Funding Agency, an executive agency of the Department for Education (DfE) For more information about how your information is processed and to access your Personal Learning Record please refer to www.gov.uk/government/plubications/lrs-privacy-notices

South Staffordshire College takes its responsibilities as a data controller very seriously and is wholly committed to only using the personal date we hold for legitimate educational purposes and to keep you informed, in accordance with the Law. The College’s privacy notice is intended to provide information about how we collect, process and store your personal data. It also explains how we might share your data with third parties and explains your rights in relation to how we use your data. Please read it carefully at https://www.southstaffs.ac.uk/privacy-policy-2/

Learner Agreement
  • I have read and understood all sections of this form and that the information I have given is to the best of my knowledge complete and correct.
  • I have declared any benefits and previous qualifications I have or receive at the time of enrolment
  • I am not enrolled or actively studying at any other Institutions.
  • I confirm that I have received advice and guidance and I agree that I am suitable for the course and have been made aware of the entry requirements and support that is available.
  • I am aware that South Staffordshire College may decide to offer a course as full cost—you should be aware that alternative funding routes may be available at other Providers
  • I agree to observe the rules and regulations of the College as set out in the Learner Conduct Policy.
  • I understand that by signing this agreement I become liable to pay the course fees and understand that if I withdraw I am still liable to pay the fees.
  • I am aware that the College’s policy is not to provide refunds of course fees except in exceptional circumstances.
  • As a learner at the College we reserve the right to contact you about your studies. If you are under 19 we will contact your parent or guardian relating to academic performance, attendance, punctuality or behaviour. If you are below the age of 16, you might wish to discuss this agreement notice with your parent or legal guardian.
  • I confirm that if unemployed and I have received remission on a state benefit other than JSA or ESA (WRAG) and that once I have obtained the skills or training required by completing my course I will be actively seeking to enter employment.
  • European Social Fund (ESF) – If you are aged 19 or over and meet the eligibility criteria, your study programme will be funded by the Education and Skills Funding Agency. As an ESF co-financing organisation, the Education and Skills Funding Agency must match ESF funds they receive with money from the UK government (that is, mainstream programme funds). Therefore, the Education and Skills Funding Agency must use some of the funding they get from the government to pay for an amount of training and support that is equivalent to their ESF allocation. This will not affect your programme or any fee levels, but we are asked to make you aware of the possibility. More information is available at: https://www.gov.uk/government/collections/sfa-european-social-fund





Please sign and continue to finish enrolling - you can use your mouse or a drawing pad, dont worry about recreating your current signature

Signature