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Accessibility Menu

Application Form

You are applying for Access to HE: Health Professions (Level 3)

Course starting *

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Student Personal Details

What statement best describes you? *

Please select an option

Title *

Please select a title

First Name (legal) *

Please enter your first name

Surname *

Please enter your surname

Known as

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Date of Birth *

Please enter your date of birth

Email Address *

Please enter a valid email address

Telephone Number *

Please enter a contact number

Sex *

Please select your sex

Gender

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Preferred Pronoun

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Student Address

Address LIne 1 *

Please enter the first line of your address

Address Line 2

Town *

Please enter your town

County *

Please enter your county

Postcode *

Please enter a valid postcode

Have you been a permanent resident of the UK/EU/EEA for 3 years or more? *

YesNo

Please select an option

Country of Residence *

Please select your country of residence

Parent/Guardian/Emergency Contact Details

If you are under 19 we require contact information for your parent, guardian or carer. If you are over 19, please provide emergency contact information.

First Name *

Please enter your contact first name

Surname *

Please enter your contact surname

Email Address *

Please enter a valid email address

Mobile/Telephone No *

Please enter a contact telephone number

Does your Parent/Guardian/Emergency Contact live at the same address? *

YesNo

Please select an option

Address Line 1 *

Please enter the first line of your contacts address

Address Line 2

Town *

Please enter your contacts town

County *

Please enter your contacts county

Postcode *

Please enter a valid postcode

Learning Support

Do you have any learning difficulties, disability or health problem *

Yes
No
Prefer not to say

Please select an option

Do you have an Educational Health Care Plan (EHCP)? *

YesNo

Please select an option

Primary Disability *

Please select your primary disability

Will you require any support or access arrangements for your interview? *

YesNo

Please select an option

If yes, then please specify *

Please enter your support requirements

Criminal Convictions

Please tell us if you have any criminal convictions *

YesNo

Please select an option

Additional Information

Previous School *

Please select an option

Are you a current Bucks College Group Student? *

YesNo

Please select an option

Are you happy for us to contact your school for a reference? *

YesNo

Please select an option

How did you hear about us? *

Please select an option

Do you have an employer who will support you through your apprenticeship? *

YesNo

Please select an option

Please add company name *

Please enter the company name

Are you planning to start in September 2026? *

YesNo

Please select an option

When are you able to start? *

Please tell us when you are able to start

I understand that the information given on this form can be used for any matter related to my application for a programme of study for the coming or future academic years, and for marketing and research purposes either by the College or by organisations employed by the College to undertake such work. I give my consent to the processing of data on this form on the understanding that the information I have supplied will be used only for the purposes set out above, and my consent is conditional upon the College complying with its obligations and duties in accordance with the College’s registration under the Data Protection Act 2018.

I accept this statement

Please read and accept the statement

isApprenticeship

Yes

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isAdult

Yes

Invalid Input

Financial Support

Student Life

Term Dates

Got a
question?

Whether you’ve got a question about applying, want to partner with us, need support during your studies, or simply want to speak to someone at your local campus, we’re ready to help you take your next step.

Aylesbury

Oxford Road
Aylesbury 
Buckinghamshire 
HP21 8PD

01296 588 588

Mon - Fri 
8:30am - 5pm

Wycombe

Spring Lane, Flackwell Heath
High Wycombe
Buckinghamshire 
HP10 9HE

01494 585 555

Mon - Fri
8:30am - 5pm

Amersham

Stanley Hill 
Amersham
Buckinghamshire
HP7 9HN

01494 585 273

Mon - Fri 
8:30am - 5pm

Application Form

Student Personal Details

Student Address

Parent/Guardian/Emergency Contact Details

Learning Support

Criminal Convictions

Additional Information

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