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
1*
2*
3*
4*
5*

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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