Please enter the details of your Parent or Guardian, or an Emergency Contact if you are over 18.
Please tick the boxes which you are affected by.
Profound complex disabilities:
Social and emotional difficulties:
Mental health difficulty:
Moderate learning difficulty:
Severe learning difficulty:
Autism spectrum disorder:
Temporary disability after illness (for example post-viral) or accident:
Speech, Language and Communication Needs:
Other physical disability:
Other specific learning difficulty (e.g. Dyspraxia):
Other medical condition (for example epilepsy, asthma, diabetes):
Other learning difficulty:
Prefer not to say:
Tick here if you have an Education Health Care Plan:
Tick here if you were subject to a statement of special educational needs while at school:
Tick here if you had any previous exam concession (reader, scribe, extra time etc.):
This will allow you to access the FRA portal to complete your application, securely upload any supporting documentation and accept an offer.