Step 1 of 3 33% Course applying for*Please indicate the course and level that you are applying for.PersonalTitle (mr / mrs / miss...)*Forenames*Surname*Date of Birth* Date Format: DD slash MM slash YYYY Gender*MaleFemaleOtherPrefer not to answerHouse No and Street*Town / VillageCity*Postcode*Telephone Number*Mobile NumberEmail* Next of Kin*Next of Kin Telephone Number*Nationality*Criminal Convictions - Do you currently have any ‘unspent’ criminal convictions, as defined by the Rehabilitation of Offenders Act?*NoYesResidency - Have you been a permanent resident in the UK/EU for the last 3 years?*NoYesAre you an asylum seeker?*NoYesAre you a refugee?*NoYesDo you have a disability? If so please click 'yes' and specify.*NoYesSpecify disability*Do you consider that you require any kind of learning support?*NoYesSpecify learning support* EducationLast School*Date From* Date Format: DD slash MM slash YYYY Date To* Date Format: DD slash MM slash YYYY Qualifications*Qualification LevelSubjectGrade Obtained / PredictedDate Completed / To Be Taken Click the plus button to add more if necessary. Personal statementPersonal Statement*Where did you find out about BMC*Have you been to a BMC open event yet?* Yes No If not, check out our upcoming open days at www.brooksbymelton.ac.uk/events. If you would like us to keep you up to date about courses and related events at BMC, please indicate your contact preferences below: Email Postal Telephone SMS You can change your contact preferences at any time by calling 01664 855 444 or emailing email@example.com. Our full privacy statement can be viewed at www.brooksbymelton.ac.uk/policies-and-procedures.CommentsThis field is for validation purposes and should be left unchanged.