CTS Education
Access to Higher Education Application Form
NOTE: This Application form should be filled by Access to Higher Education students only.
For GCSE, A-Level and Functional Skills
Click here
Personal Information
I am registering
*
Select
Myself
Someone else
Will you be responsible for paying the fees?
*
Select
Yes
No
Student's First Name :
*
Enter Names as shown on passport
Student's Middle Name:
*
Enter Names as shown on passport
Student's Last Name / Surname:
*
Enter Names as shown on passport
Student's Contact Number:
*
Student's Email Address:
*
Student's Date of Birth:
*
Gender
*
Select
Male
Female
Ethnicity
*
Select
Asian or Asian British-Bangladeshi
Asian or Asian British-Indian
Asian or Asian British-Pakistani
Asian or Asian British-any other Asian background
Black or Black British-African
Black or Black British-Caribbean
Black or Black British-any other background
Chinese
Mixed-White and Asian
Mixed-White and Black-African
Mixed-White and Black-Caribbean
Mixed-any other mixed background
White-British
White-Irish
White-any other white background
Any other
Not known/not provided
The student's address (state full address)
*
Post Code
*
The person responsible for the fees: First name(s)
*
The person responsible for the fees: Surname
*
The person responsible for the fees: Title
*
Select
Ms
Mrs
Mr
Other
The person responsible for the fees: Telephone Number
*
The person responsible for the fees: Email Address
*
The nearest centre for the student is
*
Select
Manchester
Milton Keynes
Other
Evaluate your English academic writing skills: (1=Poor 2=Fair 3=Good 4=Excellent)
*
Select
1
2
3
4
Evaluate your academic English reading skills: (1=Poor 2=Fair 3=Good 4=Excellent)
*
Select
1
2
3
4
Evaluate your academic numeracy skills: (1=Poor 2=Fair 3=Good 4=Excellent)
*
Select
1
2
3
4
Evaluate your IT skills: (1=Poor 2=Fair 3=Good 4=Excellent)
*
Select
1
2
3
4
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Other Details
Does the student have any disabilities or illnesses that would affect learning? (You will discuss this with our assessor during your interview with us).
*
Select
No disability or learning difficulties
Disabilities and learning difficulties
Learning difficulties
Disabilities
No information provided
Next of Kin / Emergency Contact Name and Surname
*
Relationship with Next of Kin / Emergency contact person
*
Next of Kin / Emergency Contact Number
*
Next of Kin / Emergency Contact Email
*
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Course Details
Name of Pathway registering for;
*
Select
Medicine
Pharmacy
Engineering
Mental Health Nursing
General Nursing
Midwifery
Physiotherapy
Podiatry
Paramedic
Occupational Therapy
Social Work
Criminology
Psychology
Cultural Studies
Business studies / Law
Marketing
Preferred starting month
*
Select
September
November
January (please note this is an intensive course and only recommended if you have recently studied
or have complete some credit already)
April
Preferred day to have lessons:
*
Select
Tuesday
Saturday
Please tell us how you heard about CTS Education?
*
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Learner Agreement
In deciding upon your choice of learning program, you have considered the implications of the following: (Cost, Time, Commitment, Organisation, Ability, Potential & Career Direction)
*
Select
Yes
No
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Submit
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