1Personal Details2Course and Qualifications3Declaration YOUR DETAILSFirst Name* Middle Name Last Name* Sex* Female Male We require your legal sex for registration with awarding bodies and funding suppliers.Preferred pronounsYour pronounsThey/ThemShe/HerHe/HimPreferred name Communications from Confetti and our partners will usually be sent with your legal name, but occasionally may use the preferred name that you provide.Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920National Insurance No. Unique Learner Number The Unique Learner Number (ULN) is a 10-digit reference number which is used alongside and to access the Personal Learning Record of anyone over the age of 13 involved in UK education or training. Learners in England, Wales, and Northern Ireland will be given their ULN by their school or FE college. It may also be printed on your exam certificate by awarding bodies.Address* Street Address Address Line 2 City ZIP / Postal Code Home PhoneMobile Phone*Email* Pick your preferred method of contact*Home PhoneMobile PhoneWork Phone (If applicable)EmailAre you over or under 18?* I am 18 or over I am under 18 Parent/guardian name*If you are under the age of 18, please provide the name of one of your parents/guardians. First Last Parent/guardian email* Parent/guardian phone number*Second parent/guardian name (if applicable)If you are under the age of 18, please provide the name of one of your parents/guardians. First Last Second parent/guardian email (if applicable) Second parent/guardian phone number (if applicable)Emergency contact name* First Last Emergency contact email* Emergency contact phone number*Relationship to you*Please chooseMotherFatherStep MumStep DadGrandparentBrotherSisterAuntieUncleGuardianCarerSecond emergency contact name (if applicable) First Last Second emergency contact email (if applicable) Second emergency contact phone number (if applicable)Relationship to youPlease chooseMotherFatherStep MumStep DadGrandparentBrotherSisterAuntieUncleGuardianCarerETHNIC ORIGINHow would you describe your ethnic origin?*Please chooseBritish / Welsh / Scottish / Northern IrishIrishGypsy or Irish TravellerAny other White BackgroundWhite and Black CaribbeanWhite and Black AfricanWhite and AsianAny other Mixed / Multiple Ethnic BackgroundIndianPakistaniBangladeshiChineseAny other Asian BackgroundAfricanCaribbeanAny other Black / African / Caribbean BackgroundArabAny other Ethnic GroupPrefer not to sayWhat is your nationality?*Please chooseAfghanAlbanianAlgerianAmericanAndorranAngolanAntiguansArgentineanArmenianAustralianAustrianAzerbaijaniBahamianBahrainiBangladeshiBarbadianBarbudansBatswanaBelarusianBelgianBelizeanBenineseBhutaneseBolivianBosnianBrazilianBritishBruneianBulgarianBurkinabeBurmeseBurundianCambodianCameroonianCanadianCape VerdeanCentral AfricanChadianChileanChineseColombianComoranCongoleseCosta RicanCroatianCubanCypriotCzechDanishDjiboutiDominicanDutchEast TimoreseEcuadoreanEgyptianEmirianEquatorial GuineanEritreanEstonianEthiopianFijianFilipinoFinnishFrenchGaboneseGambianGeorgianGermanGhanaianGreekGrenadianGuatemalanGuinea-BissauanGuineanGuyaneseHaitianHerzegovinianHonduranHungarianI-KiribatiIcelanderIndianIndonesianIranianIraqiIrishIsraeliItalianIvorianJamaicanJapaneseJordanianKazakhstaniKenyanKittian and NevisianKuwaitiKyrgyzLaotianLatvianLebaneseLiberianLibyanLiechtensteinerLithuanianLuxembourgerMacedonianMalagasyMalawianMalaysianMaldivianMalianMalteseMarshalleseMauritanianMauritianMexicanMicronesianMoldovanMonacanMongolianMoroccanMosothoMotswanaMozambicanNamibianNauruanNepaleseNew ZealanderNi-VanuatuNicaraguanNigerianNigerienNorth KoreanNorthern IrishNorwegianOmaniPakistaniPalauanPanamanianPapua New GuineanParaguayanPeruvianPolishPortugueseQatariRomanianRussianRwandanSaint LucianSalvadoranSamoanSan MarineseSao TomeanSaudiScottishSenegaleseSerbianSeychelloisSierra LeoneanSingaporeanSlovakianSlovenianSolomon IslanderSomaliSouth AfricanSouth KoreanSpanishSri LankanSudaneseSurinamerSwaziSwedishSwissSyrianTaiwaneseTajikTanzanianThaiTogoleseTonganTrinidadian or TobagonianTunisianTurkishTuvaluanUgandanUkrainianUruguayanUzbekistaniVenezuelanVietnameseWelshYemeniteZambianZimbabweanAre you an asylum seeker?* Yes No Do you have refugee status?* Yes No Have you lived in the UK for the whole of the last three years?* Yes No If no, please state where you have lived (a fee assessment may be required before proceeding) If you have answered no, are you a national of an EU/EEA country? Yes No Do you have EU Settlement Scheme Status? Yes No If yes, which status do you have? Settled Pre-settled If no, did you apply for EU Settlement Scheme before 30 June 2021 Yes No ADDITIONAL NEEDS AND EXTRA SUPPORTAt Confetti, we use person centred approaches to ensure that you are supported to make progress, and to maximise your future potential as an independent learner. We ask you to share as much information as you are willing, and to provide additional evidence (if you have any), so that we can plan your support with you. All information is treated confidentially and will only be shared within the Confetti team, in support of your learning. You will be contacted to arrange a support assessment if required.Are you in care of the local authority or with the leaving care team?* Yes No Are you or have you been subject to a Child Protection or Child in Need plan?* Yes No Do you have an Education, Health and Care Plan?* Yes No An Education, Health and Care plan (“EHC plan”) is a legal document which describes a child or young person's special educational needs, the support they need, and the outcomes they would like to achieve. Please submit a copy of your EHCP to supportdocs@confetti.ac.uk.Do you have any additional learning need which will require extra support?* Yes No If you have declared an additional learning need, you need to fill in our Specific Learning Difficulties checklist after you complete your application. This takes about 5 minutes and you can do it online. You will find this on the confirmation page. Please let us know any additional learning needs: Autistic Spectrum Attention Deficit Hyperactivity Disorder (ADHD) Obsessive Compulsive Disorder (OCD) Pathological Demand Avoidance (PDA) Dyslexia Attention Deficit Disorder (ADD) Dyspraxia Dyscalculia Dysgraphia Cerebral Palsy Learning Difficulty Physical disability Visual impairment (VI) Hearing impairment (HI) Long-term mental health condition Social, emotional and mental health (SEMH) Epilepsy Long-term condition What support have you had in the last 3 years of your education?* 1:1 class support Shared in class support 1:1 support sessions Small group sessions Note taking or alternative technologies Specialist equipment Exam concessions Local authority transport Counselling or pastoral support Other Please give as much detail regarding your previous support as possibleWe need you to provide details for each individual form of support you have ticked on the question above.Please submit the applicable attachments below to supportdocs@confetti-live.com in order to progress your application. Education Health and Care Plan (EHCP) Diagnosis Exam concession reports Health reports Medication that will need to be taken on site Do any of the following wellbeing concerns affect you? Young carer / carer Substance dependency / misuse Self harm Suicidal ideation Support from Social Worker / Support agency Other (please specify) If other, please specify Please provide further information where appropriate COURSE DETAILSWhich course are you applying for? (Tick those that apply.)* Level 1 - Introduction to the Creative Industries - AIM Level 2 - Digital Video & Photography - BTEC Level 2 - Games – AIM Level 2 - Music Performance – BTEC Level 2 - Music Technology - BTEC Level 3 - Film & TV Production - BTEC Level 3 - VFX & Animation - BTEC Level 3 - Graphics & Digital Design – BTEC Level 3 - Audio & Music Technology - BTEC Level 3 - Music Performance & Songwriting - BTEC Level 3 - Technical Events – BTEC Level 3 - Games Technology – BTEC Level 3 - Games Art - BTEC Level 3 - Esports - BTEC QUALIFICATIONSList all qualifications you are taking or have already achieved. For year 11 school leavers please write down your predicted grades.Most recent school/college* Grades*Qualification (E.g. GCSE English, A Level Maths, BTEC L2 Diploma in Media.)Predicted GradeGrade AchievedYear of Exam If you don't have any formal qualifications, please write NONE in the Qualification field.Have you attended Confetti before?* Yes No Have you applied elsewhere?* Yes No If yes, please say where: HOW DID YOU FIND US?Where have you seen Confetti advertised?* I heard a radio/digital radio/online streaming service advert I saw a bus advert I saw a tram advert I saw a TV advert I saw a cinema advert I saw a post on Twitter/Facebook/Instagram I saw a video on YouTube I searched on Google/Bing/other search engine I spoke to someone at a UCAS Fair I was advised by a referral agency (Futures, Job Centre etc.) I spoke to someone at my school/college careers event I attended a taster session with my school I visited Confetti with my school I was advised by my school/college advisor/tutor I was advised by a friend/family member Other (please specify below) Tick as many boxes as requiredComments YOUR DECLARATIONHave you any unspent criminal convictions?* Yes No Are you currently on probation or serving a non-custodial sentence or awaiting court cases?* Yes No Are you currently on any orders, e.g. SOPO, ASBO?* Yes No Signature*Confetti Media Group (CMG) positively welcomes students and customers from all communities. I declare the information given on this form is correct and accurate to the best of my knowledge, and I understand that information I supply will be held by CMG and shared with third parties in order to provide CMG’s services, as outlined in our Privacy Notices. By signing this declaration I am providing consent for CMG to contact my referees using the contact details supplied and others agencies in regards to my application. Further information regarding how we process, store, and use your data can be found in our Privacy Notices – available here https://confetti.ac.uk/privacy-policy/ I have read and understood the declaration