Student application form

(UNDERGRADUATE / POSTGRADUATE, FULL & PART-TIME)

Please complete using BLOCK CAPITALS

    1. YOUR DETAILS *
    Given name:
    Surname:
    Permanent Home Address:
    Marital status:
    City:
    State / Province / Region:
    Country:
    Date of Birth (yy/mm/dd)
    Country of Birth:
    ZIP / Post code:
    Nationality:
    Telephone Number:
    Email Address
    Messenger Number
    WhatsApp:
    Telegram:
    Viber:
    Other:
    2. WHICH COURSE DO YOU WANT TO STUDY? *
    Enter the course for which you wish to be considered in order of preference:
    Levels:
    A1 – elementary (Beginner / Elementary).
    A2 – basic (Elementary/Pre-intermediate).
    B1 – threshold level (Intermediate).
    B2 – post-threshold level (Upper-Intermediate).
    С1 – advanced speaker level (Advanced)
    Application for entry in the academic year
    3. SCHOOL DETAILS *
    Name of High School(s) attended:
    Town/City:
    From:
    To:
    Examining Body:
    Subject Level:
    Result (Grade mark or %):
    Exam Date:
    4. COLLEGE / UNIVERSITY QUALIFICATIONS GAINED *
    Graduated (college/university):
    Name of College or University attended:
    Town / City:
    From:
    To:
    Please list the subjects studied and the qualification achieved (Attach a copy of your Certificates or marks sheet).
    Institution Name:
    Course of Study:
    Award Title:
    Grade/Class:
    Date Obtained:
    QUALIFICATIONS NOT YET COMPLETED OR CERTIFIED
    Name of College or University attended:
    Town / City:
    From:
    To:
    Date of results of Examination or Awards:
    Awarding Body:
    Subject / Unit / Module / Component:
    Level / Qualification:
    5. ENGLISH LANGUAGE QUALIFICATIONS *
    Please indicate whether English is:
    Please state qualifications gained and attach documentary evidence showing level of proficiency obtained in TOEFL examination/IELTS examination OR equivalent other test of English language skills.
    Examination name:
    Points / level:
    6. OTHER LANGUAGE QUALIFICATIONS *
    7. WORK EXPERIENCE AND EMPLOYMENT *
    Employers Name:
    Job Title:
    From:
    To:
    8. REFERENCES
    Name of Referee 1:
    Position / Occupation / Relationship to applicant:
    E-mail of Referee:
    Telephone Number:
    Name of Referee 2:
    Position / Occupation / Relationship to applicant:
    E-mail of Referee:
    Telephone Number:
    9. CRIMINAL CONVICTIONS *
    Do you have any criminal convictions?
    10. COURSE FEES *
    Who is responsible for payment of course fees? Tick appropriate box
    11. EMERGENCY CONTACT *
    Name:
    Status:
    Email:
    Telephone Number:
    Messenger Number:
    WhatsApp:
    Telegram:
    Viber:
    Other:
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