English / Cymraeg

Education Maintenance Allowance (EMA)

EMA Agreement Form 2022/23

This is your Learning Agreement form:

School/College Name

Student Forename

Student Surname

Student Date Of Birth

Customer Reference Number

Student ID Number

Student Agreement

Please read this agreement carefully We can only progress your application for EMA if your school or college has confirmed that you have signed and dated this agreement

  • I confirm that the information I have previously submitted is still correct and that I have notified any changes thereto in accordance with my original application terms.
  • I understand that any attempt to dishonestly obtain EMA shall be treated as fraud and may result in criminal and/or civil proceedings against me
  • I understand that as part of the EMA, the information which I have provided maybe subject to review as part of a sample check.

Preferred correspondence language

What language would you like us to use when we communciate with you?

Consent to share

Do you consent to your college sharing your information with your parent(s) or partner?

Extenuating Circumstances

Are you currently aware of any extenuating circumstances that may affect your attendance (for example, you help to provide care for a family member who is ill or disabled)? You should inform your college if you become aware at any time of extenuating circumstances that may affect your attendance.

Course Details

Please enter your course name, tutor name and campus:

Attendance Criteria

Signature

Student