FOR OFFICE USE ONLY Reg. No.

International Application Form

for Summer Courses
Taught Programmes
1. Personal details (Please refer to Notes for Guidance)
Surname/Family Name

2. Further Details (Please refer to Notes for Guidance)

Age

First Name(s)

Years

Permanent Address

Months

Male (M) Female (F)

Date of birth
Postcode

DD / MM / YY

Home contact numbers

(inc. STD/Area Code)

Tel:
Fax:

Disability/special needs (refer to Notes for Guidance)

Email:
Correspondence address (if different)

Country of permanent residence____________________________

Country of birth _______________________________________
Nationality ___________________________________________

Postcode
Contact numbers
(inc. STD/Area Code)

Tel:
Fax:

Passport No. (if available) _______________________________

Email:
3. Details of course for which you wish to apply (Please refer to Notes for Guidance)
Summer course applied for

Foundation

Design Workshop

Month and year in which you wish to start:

Full course title:

1st choice
2nd choice
3rd choice

Please indicate how you heard of this course (provide name of Agent if applicable)
4. Details of intended Fee Payment arrangements (Please refer to Notes for Guidance)
i. I will be paying my own tuition fees - Please tick -

Yes

No

ii. I will be in receipt of a grant or scholarship (please give details)

Yes

No

iii. I will be sponsored by my employer or other organisation

Yes

No

(please give details to enable us to contact your sponsors & arrange any necessary administration)
5. Physical or other disability or medical condition which might necessitate special arrangements or facilities:

6. Qualifications Please provide full details of educational background including institution name and dates attended, qualifications obtained, subjects and grades. Please attach photocopies of transcripts or certificates if available (please refer to Notes for Guidance)
Institution Name
Dates attended

From (month & year)

To (month & year)

From (month & year)

To (month & year)

From (month & year)

To (month & year)

Qualifications

Institution Name
Dates attended
Qualifications

Institution Name
Dates attended
Qualifications

7. If your first language is not English, please state which qualifications (eg, GCSE, IELTS, TOEFL) in English Language you hold or are
currently studying, the score or grade if known and date taken. Please attached a photocopy of transcript or certificate if available.
Qualification:

Score or Grade:

Date taken:

Qualification:

Score or Grade:

Date taken:

8. Declaration
I confirm that the information given on this form is true, complete and accurate and no information requested or other significant information has
been omitted. I have read the Notes for Guidance for Completion of the Application Form. I confirm that I have completed and signed this form
myself.

Applicants Signature: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date: . . . . . . . . . . . . . . . . . . . .