Learner Support Fund Application Form 19+ years

Which year are you applying for support?
Student's First Name *
Student's Last Name *
Email *
Contact number *
First Line of Address *
Second Line of Address *
City *
Postcode *
Leicester College ID number *
Name of Course Applied For *
Course Level *
Your Age on 31 August 2024 *
Date of Birth *
Are You one of the below?
Marital Status
Do you have an Educational Health Care Plan (EHCP)?
Tell us which countries you have lived in for the past three years *
Date of entry to UK (if applicable)
Are you an Asylum Seeker? *
Are you a Refugee? *

Only answer the following 3 questions if you are applying for a Level 3 course

If you are aged 19-23, is this your first full level 3 course?
Have you applied for an Advanced Learner Loans?
Do you intend to apply for an Advanced Learner Loan?
Please tell us why you are applying for support. *
Please list the full names of all the people who live in your household at the same address as you, their relationship to you and their age if under 18. *
If you live alone, please put in n/a
Please select from the list here what you need help with. Funding is limited. If you cancel or withdraw from your course bus passes and kit will need to be returned. *
Do you intend to buy your own kit before enrolment? If so, please keep your receipts to claim this money back
Travel to and from college *
IMPORTANT MESSAGE REGARDING TRAVEL. For all new 16-18 Students you must live 3 miles from Home to Campus to qualify for Travel Assistance. For returning Students, we will offer one year Transitional Protection therefore if you qualified for Travel Assistance in 23/24 and your circumstances have remained the same, we will assist you. From 25/26 all 16-18 year olds will need to live a minimum of 3 miles from Home to Campus to qualify for Travel Assistance.
Do you need help with paying for childcare?
First child's full name
First child's date of birth
Second child's full name
Second child's date of birth
Third child's full name
Third child's date of birth

I understand that the information provided in this form is necessary for Leicester College to carry out its role in providing further education and I give my consent to the College to process this data for the purposes of managing my application for learner support.

Please check this box to indicate that you agree *

I understand that any assistance provided is subject to enrolling on a course of study and maintaining satisfactory levels of attendance and progression, and agree that consultation may take place with my tutor.

Please check this box to indicate that you agree *

I have read the Privacy Notice for Students who access support and I understand that the information that I provide will be used in accordance with the General Data Protection Regulations (GDPR) and the UK Data Protection legislation. https://leicestercollege.ac.uk/about-us/corporate-information/data-protection/all-privacy-notices

Please check this box to indicate that you agree *
If you have applied for help with childcare please check the boxes below to show that you agree with the following. Any changes of nursery/childminder must be discussed and agreed in advance with a Welfare Adviser. *

Evidence required. As the fund is a hardship fund, it is dependent upon household income. • For students aged 19, living at home and supported financially by parent(s); partner you live with; carer; support can be based on the parent(s); partner; carer’s wages and/or benefits. For 19+ aged students the support is based on the student’s income/benefits and the income/benefits of a partner if they live with you.

Please select one that applies to you *
Student Signature (type in your full name) *
Parent/Carer Signature (type in the full name) *
Do you live in care or are you a care leaver?
Are you in receipt of Income Support or ESA, AND Disability Living Allowance or PIP? You will need to provide proof of this.

Need help?

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