Southampton City College : Personal Referral Form

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Personal Referral Form

Please note: Certain information is mandatory on this form to ensure we can process your enquiry quickly and efficiently, these fields are denoted by a yellow background.

Referral
Referred By:
Friends Name:
Comments:

Your Details
Name:
Address:
Telephone:
DOB:
School:

Bright Futures / Talk to Us If you are interested in our Summer School, please select a date from the list below. Or if you just want to come in to talk to us, select 'Discuss my Options'.
Dates:
Area/Interest:
Area/Interest:

I confirm I have (or am predicted) GCSE Level C or above in Maths & English.

I confirm that I have overseas equivalent GCSE Level C or above in Maths & English I confirm by submitting this form I am authorising City College Group to view and use this information to assess and support the Young Person with their application to City Horizons. All information will be kept strictly confidential. Please note you must have the Young Persons permission to disclose information enclosed in this form. Please also be aware that we contact your previous school or college for additional or verification of information. If you require further information please contact the City Horizons team by calling 023 80 63 16 58 or by emailing referral@southampton-city.ac.uk.

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Referral

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