Apply Today – An exciting and innovative partnership between Pencoed Comprehensive School and Bridgend College

Step 1 of 4

A little about you
Surname*
First Name(s)*
Date of Birth*
Date Format: MM slash DD slash YYYY
Address*
Street Address City Post Code
Home Telephone Number*
Mobile
Email

Your Education
Name and dates of the previous school/college you attended (if applicable)
School/College Dates
QUALIFICATION DETAILS
Level – GCSE/BTEC Subject Grade
Choice of subjects
A
B
C
D
E
Twilight
Do you have any subjects that you’d like to take but clash? If yes please state below

Learner Support
Please give details of any learning difficulties or disabilities you may have? This will enable us to provide you with the support you may need.*
Do you have any health problems the college needs to be aware of*
- No
- Yes
If yes, please give detail: (eg.asthma, epilepsy, diabetes etc)

Emergency Contact
Emergency Contact Name 1
First Last
Emergency Contact Address 1*
Street Address City Post Code
Emergency Contact Number 1
Emergency Contact Email 1
Emergency Contact Name 2
First Last
Emergency Contact Address 2*
Street Address City Post Code
Emergency Contact Number 2*
Emergency Contact Email 2*

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