SUBJECT KNOWLEDGE
ENHANCEMENT APPLICATION FORM
2016/17 ENTRY
SECTION A – PERSONAL DETAILS (Please complete all sections)
A1 Student Information
Student Number
B
(OFFICE USE ONLY)
1
2
3
4
5
6
7
Have QTS year obtained/Not Applicable
QTS Status
Programme of study
Title (Mr/Miss/Mrs/Dr. etc.)
Subject Knowledge Enhancement
Surname/Family Name
Programme start date
Forename Name(s)
Mode of Study
Date of Birth
DD/MM/YYYY
Sex
Male (1)
Student Fee Status*
Female (2)
Home
Full-time
European Union
Part-time
Channel Islands & IoM
Overseas
Other (3)
A2 Permanent Address (At Application)
A3 Emergency Contact Details
Name
Relationship to you
Contact number primary
Contact number primary
Personal Email:
Contact Numbers:
Contact number secondary
T:
M:
SECTION B – BIOGRAPHICAL DETAILS
B1 Prior HE Experience
Have you had prior Higher
Education experience in the UK
lasting 6 months or more?
(Please tick appropriate box)
Yes (A)
No (B)
B2 Country of Domicile
Please check/state the country of your
permanent home/address prior to entry on
this course (if blank please complete)
England (XF)
N. Ireland (XG)
Scotland (XH)
Wales (XI)
Have you been looked after by a
Local Authority for at least 13
weeks since the age of 14?
B6 Ethnic Origin (tick box)
A specific learning difficulty such as dyslexia, dyspraxia or
AD(H)D (51)
A social/communication impairment such as Asperger’s
syndrome/other autistic spectrum disorder (53)
A long standing illness or health condition such as cancer, HIV,
diabetes, chronic heart disease, or epilepsy (54)
A mental health condition, such as depression, schizophrenia or
anxiety disorder (55)
A physical impairment or mobility issues such as difficulty
using arms or using a wheelchair or crutches (56)
Deaf or a serious hearing impairment (57)
Asian or Asian British - Indian (31) Asian
or Asian British - Pakistani (32) Asian
or Asian British - Bangladeshi (33)
Other Asian Background (39)
Christian (03)
Hindu (10)
Chinese (34)
Mixed - White & Black Caribbean (41)
Jewish (11)
Mixed - White & Black African (42)
Any other religion or belief (80)
Information refused (9)
Multiple Disabilities (08)
Buddhist (02)
Spiritual (14)
--------------------------------B7 Disability (tick box)
Black or Black British - Caribbean (21)
Other Black Background (29)
Sikh (13)
Don't Know (8)
No known disability (00)
No
Muslim (12)
If other please specify:
Gypsy or Traveller (15)
Black or Black British - African (22)
No religion (01)
Other
White (10)
Yes
B8 Religion
UK (GB)
B4 Parental Education
Do any of your parents (natural,
adoptive or step) have higher
education qualifications (degree,
CertHE, DipHE), Please tick the
appropriate box.
Yes (1)
No (2)
Other If other please specify:
----------------------------------------------
B5 Care Leaver
B3 Nationality
Mixed - White & Asian (43)
Other Mixed Background (49)
Arab (50)
Other Ethnic Background (80)
Information refused (98)
Information refused (98)
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Blind or a serious visual impairment uncorrected by
glasses (58)
A disability not listed above (96)
Are in receipt of Disabled Students Allowance (DSA)? (4)
SUBJECT KNOWLEDGE
ENHANCEMENT APPLICATION FORM
2016/17 ENTRY
SECTION C –QUALIFICATION(S) ON ENTRY
C1 – Last Institution Attended
Name of College/University
C2 Highest qualification on entry
Level of highest qualification on entry (e.g. A levels, first degree, PGCE)
Year left
Institution (if different from C1 above)
If highest qualification is A’Levels or equivalent, please skip the rest of this section and list them in section C3 below
Title of Award (e.g. BA Honours Degree, PGCE, etc.)
Subject(s) of Award
Classification
From
Do you already have Qualified Teacher Status?
Yes
MM/YYYY
To
MM/YYYY
No
C3 – Qualification Details (please list all qualifications achieved to-date use a continuation sheet if necessary)
Type
Grade
Awarding Body
Subject
Year
C4 – English Language Competency
Is English your first language?
If English is not your first language please
state IELTS/TOEFL score(s)
Reading
Listening
Writing
Speaking
SECTION D – ELIGIBILITY FOR BURSARY
D1 – COURSE DETAILS
You must have accepted a conditional offer of a place, which may be a deferred place, on a post graduate ITT programme in
one of the Subject Knowledge Enhancement eligible subjects prior to enrolling on this programme.
Lead School Name
Lead School Post Code
ITT Contact Name*
ITT preferred email
address
ITT Provider Name
ITT Programme Subject
ITT Programme Start Date
ITT Programme End Date
ITT Provider ID number
Will the ITT course require deferral in order to complete the SKE course? Yes / No?
*The ITT provider will be contacted prior to a place being offered on our SKE courses.
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SUBJECT KNOWLEDGE
ENHANCEMENT APPLICATION FORM
2016/17 ENTRY
D2 – ELIGIBILITY CRITERIA FOR RECEIVING A BURSARY
On receipt of this application your eligibility for a bursary will be assessed by Bishop Grosseteste University*. To assess your
eligibility for a bursary please complete the following questions:Are you registered or on another course of Initial Teacher Training or Subject Knowledge Enhancement as
this could affect your eligibility for receiving the bursary.
YES
NO
Have you for the three years preceding the start of this course been ordinarily resident in the UK/EU or
islands wholly or mainly for the purposes other than receiving full-time education?
YES
NO
*All offers are subject to funding being agreed.
D3 – ELIGIBLE ITT SUBJECTS
Subject
Degree Grade gained
*A’ Level grade gained
Please tick your chosen
SKE subject
Physics*
Mathematics*
Chemistry
Languages: French
Languages: German
Languages: Spanish
Geography
Biology
* Trainee teachers in maths and physics with a relevant 3rd class degree require at least a B at A level in maths, further maths or
physics to meet this criterion for the SKE training bursary. Trainees with a 2:2 or above do not need the A level to meet this
criteria for the SKE bursary.
E3 – BANK DETAILS
Bank Name
Bank Branch
Sort Code
Name of the Account Holder
Account/Roll Number
Terms & Conditions
You must promptly inform Bishop Grosseteste University of any changes to your bank, address details and any intention to
withdraw. Non completion of the course will affect your bursary payment. If eligible for a bursary and subject to availability
of funding from NCTL, bursary payments will be made in two equal installments on the 1st July 2016 and 1st August 2016.
If a false claim has been made or ineligibility is determined, Bishop Grosseteste University will seek to recover bursary
payments from individuals.
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SUBJECT KNOWLEDGE
ENHANCEMENT APPLICATION FORM
2016/17 ENTRY
Career History
Supporting Statement
Please show how your previous academic studies, experience, knowledge, skills, interests and personal attributes will equip you to join the
programme:
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SUBJECT KNOWLEDGE
ENHANCEMENT APPLICATION FORM
Referees:
2016/17 ENTRY
Open Reference – Please explain why, in your professional judgement, this candidate has the potential to study and succeed.
Open Referee
Name:
Second Referee
Name
Address:
Address:
Telephone Number:
Telephone Number:
Email:
Email:
I declare that the information I have provided about my qualifications and experience in this application is
true. I confirm I understand the Terms and Conditions above.
Applicant Signature
DD/MM/YY
Applications should be sent to:
Admissions
Bishop Grosseteste University
Lincoln
LN1 3DY
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