Online Short Courses Application Course First Steps to Christian CounsellingChristian ApologeticsHow to study and communicate the Bible Name/Contact Details Surname: Title (Mr/Mrs etc.) First Name(s): Sex (M/F): MaleFemale Name you prefer to be called by: Date of Birth: Nationality: House Number/Street: Area/Locality: Town/City: County/Province/State: Country: Postcode/Zip: Tel: Mob: Your Email: Physical Disability / Learning Difficulty / Health Do you have any physical disability, learning difficulty or health problem that might affect your studies? If so, please give details: English Language Ability I do not have English as a first LanguageAll my secondary and higher education was through the medium of English ESOL/EFL test results (IELTS, Cambridge or equivalent). Please note a formal test is MANDATORY unless you have ticked the second box above. Criminal Convictions BCC has a duty to ensure the safety and security of its students and staff. Please tick the relevant box below: Do you have any criminal convictions? YesNo If 'Yes' please give details with dates (excluding motor offences etc.): Declaration I confirm that the information given on this form is true, complete and accurate and that I have not withheld any information relevant to my application. I understand that in accordance with the Data Protection Act my information will be held electronically. I give my consent to the processing and storing of my data by Birmingham Christian College as detailed within the Student Privacy Notice. I understand that any offer of a place as a student received will be based on the information given in this application and that if I am found to have supplied false information, any such offer will be withdrawn. Signed: Date: Equal Opportunities Monitoring Information Information on ethnicity and/or disability will not be used in reaching a decision on the outcome of your application. Ethnic Origin WhiteBlack/British CaribbeanBlack/British AfricanBlack (Other)Asian/British PakistaniAsian/British BangladeshiAsian/British IndianAsian/British ChineseAsian (Other)White/Black CaribbeanWhite/Black AfricanWhite/AsianOtherDo not wish to specifyNot Known Disabilities (tick all that apply) AutisticBlind/Visually impairedDeaf/Hearing impairedDyslexiaOther Learning DifficultyMental Health needsMobility problemsMultiple disabilitiesUnseen disabilityOther If you selected 'Other' please specify: Finding out about Birmingham Christian College How did you first learn about Birmingham Christian College (please tick)? Internet SearchChurch/PastorFriendCurrent/Former StudentPress AdvertRadio AdvertOther If you selected 'Other' please specify: Additional Information If you would like to be included on our mailing list to receive information and news about the college, special events and other courses of interest please tick this box.