• A  A  A  

Personal Details

Please give your full name as shown on your birth certificate or passport. Print clearly.

Date of Birth
Age on 1st September 2022

Country of birth
Have you lived in the UK for the last 3 years?
If you were not born in the UK, what date did you come to live here?

If you are Catholic, what is your Parish?
Have you applied to this college before?

Home Address

House number/name and street
Street address 2 (optional)
Home phone number
Your mobile number
Your e-mail address

Emergency Contact

Name of Parent/Carer
What is their relationship to you?
Parent/Carer phone number
Parent/Carer email address

Please give their address (if it is different to yours).

House number/name and street
Street address 2 (optional)

If any of your brothers or sisters have attended Xaverian please give name(s) and leaving date(s):
Do you live independently?
If you are a young carer for a family member, please give details:


Please list all the schools/colleges you have attended:

Primary School
Year from
Year to
Secondary School
Year from
Year to
Year from
Year to

Subject choices

Please list the courses you would like to study, in order of preference

Subject Choice 1
Subject Choice 2
Subject Choice 3
What career are you considering?

Disability and Health

Xaverian College is committed to ensuring that students with learning difficulties and disabilities are treated fairly.

Do you have a disability, learning difficulty or health condition?
If Yes, please tick the relevant boxes
If you have checked any of the conditions above, please give further details below regarding the support or adjustments you need in college:


If you were not born in the UK or EU please indicate your current residential status in the UK:

If Limited Leave, what is the date of expiry for your visa?


Xaverian College is asked by the Skills Funding Agency to return the ethnic origin for each student. The information provided will be used as statistical data only and will be treated in the utmost confidence. Please tick one box below:

Black/African/Caribbean/Black British
Mixed/Multi Ethnic Group
Other Ethnic group
Asian/Asian British

Examinations - estimates and results

Please list below all the examinations you have taken and the details of any you will be taking next summer

Date of examination
(e.g: GCSE/BTEC)

Please upload a copy of your certificates or statement of results for any exams you have already taken.
Maximum file size: 256 MB

General Information

(We encourage students to include a personal statement whenever possible)

General interests and positions of responsibility (clubs, teams, music, choir etc.)
Why have you applied to Xaverian College?

It is a condition of admission to a programme of study that the candidate has accurately and truthfully presented all the relevant facts in their application. The College retains the right to withdraw an offer of a place or terminate the registration of a student should it subsequently come to light that the information provided by an applicant in support of their application was inaccurate, incomplete or a misrepresentation of the applicant's academic, social or other achievements. Also, should matters come to light that would be deemed, having conducted a standard college risk assessment, to run counter to Xaverian College's Mission, statutory, safeguarding or contractual duties to its staff or students, the offer of a college place will be withdrawn.