19 – 23 Student Declaration
First Full Level 2
First Full Level 3
I confirm that all the information on this form is correct, I am aged 19 - 23 and I declare that I
do not already have a full level 2 and/or a full level 3 qualification and I have enrolled onto a
first full Level 2 or 3 learning aim (delivered as part of the legal entitlement).
I understand that my prior qualifications will be verified by Leicester College and that if
I have declared false information the provider may take action against me at any time
during my course to reclaim the tuition fees and any support costs provided.
An explanation of the qualification levels is available on request from the Information Centres.
Person Code
Name
Course
Signed (Learner)
Please tick appropriate box
Aged 19 to 23 on the day your qualification starts and on a FIRST full level 2
programme
L223
Aged 19 to 23 on the day your qualification starts and on a FIRST full level 3
programme
L323
Date____________
As course tutor, I confirm that the student does not already have a full level 2 and/or a full level 3
qualification and has enrolled onto a first full Level 2 or 3 learning aim (delivered as part of the legal
entitlement).
Tutor’s name (please print)
Signed (course tutor)
Leicester College Address:
Leicester College
Freemen’s Park campus
Welford Road
Leicester
LE2 7LW
For office use (FACT Staff only)
Learning aim
Aim has legal entitlement
Y/N
Confirmed First full level 2/3
Y/N
Age of learner
FACT Waiver applied
Y/N
If no state reason:
Copies to:
White - Info Centre
Green - FACT
Date returned to IC:
Signed
Date