Enquiry Form/Taster Day Booking Form - Pinc College

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Enquiry Form

Taster Day Booking Form

Pinc College is a Specialist College for Creative Education, for young people aged 16-25 with EHCP’s. We have several Creative Learning Studios that provide an art based curriculum, individually tailored to meet your needs and aspirations.

We look forward to working with you.

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Student Details

First Name *

Last Name *

Preferred To Be Known As

Pronoun

Address *

Date of Birth *

Home Phone Number *

Mobile Number *

Student Email *

I can confirm that I/The Student can manage a 5 day timetable?

Yes

What grades have you achieved in GCSE English and Maths?

Yes

No

Please click your 1st choice campus *

Manchester Museum

Salford Art Gallery

Bolton Museum

Touchstones, Rochdale

Heritage Centre, Macclesfield,

Leeds Art Gallery, Leeds,

Cartwright Hall, Bradford,

Dean Clough, Halifax,

Aston Hall, Birmingham

The Potteries Museum & Art Gallery, Stoke

Middleport Pottery

National Museum, Cardiff

Please click your 2nd choice campus *

Manchester Museum

Salford Art Gallery

Bolton Museum

Touchstones, Rochdale

Heritage Centre, Macclesfield,

Leeds Art Gallery, Leeds,

Cartwright Hall, Bradford,

Dean Clough, Halifax,

Aston Hall, Birmingham

The Potteries Museum & Art Gallery, Stoke

Middleport Pottery

National Museum, Cardiff

Proposed Start Date

Your Local Authority

Local Authority SEND case worker

Social Worker (If you have one)

Known SEND need. Tick all that apply *

ADHD

Anxiety

ASC/Autism

Cerebral Palsy

Dyslexia

Dyspraxia

Epilepsy

Hearing impairment

Mental health difficulties

Physical disability

Visual impairment

Other

Your creative interests and other things about you that you would us to know

Does the young person have an EHCP/ Statement (Wales) *

Yes

No

Does the young person have any Safeguarding incidents/issues and/or a Risk Assessment *

Yes

No

Parents / Carers / Corporate Parent

First Name *

Last Name *

Mobile Number *

Email *

Relationship to Student

Address (If Different)

EMERGENCY CONTACT DETAILS IF DIFFERENT TO ABOVE

Name

Relationship to Student

Telephone

Education

Current School or College

Address

Date From/To

Most Recent Attendance (Average)

Below 20% 20% - 50% 50% - 80% Above 80%

Wellbeing

Good Some Concerns Req. Intervention

Overall Attainment

Excelling Some Concerns No Progress

Qualifications

SUBJECT 1

Grade or Expected Grade

Date (Year) Completed/Expected

SUBJECT 2

Grade or Expected Grade

Date (Year) Completed/Expected

SUBJECT 3

Grade or Expected Grade

Date (Year) Completed/Expected

SUBJECT 4

Grade or Expected Grade

Date (Year) Completed/Expected

Email us on [email protected]

View Term Dates (pdf)

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UKPRN 10066798
UPIN 163974

ESFA Section 41 Approved

URN 149344

Email us on
[email protected]

View Term Dates (PDF)

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