Application Form 2010/2011: Section 1: Your Personal Details
Application Form 2010/2011: Section 1: Your Personal Details
Please complete only the BORDERED WHITE BOXES of the form in BLOCK CAPITALS and in ink Office Course Information Centre, Westminster Kingsway College, St Jamess Park Centre, Castle Lane, London SW1E 6DR use only
Please enter your name as it appears on official documents: Title: Male Female AG
Please enter your address including postcode (please remember to let us know if you move house after applying): Own home Other: Please state
Section 5: Residency.
Have you lived in the UK all of your life? Yes No If No, when did you come to the UK? (month/year) M How long did you live there? When does it expire? M
M Y Y M Y Y
In which country did you live before entering the UK? Do you have a visa? Yes No If yes, what type?
years
Date ended M M Y Y Please list any qualifications you have, or expect to obtain before you start your course. If English is not your first language, you must indicate which English language exams you have taken and passed. CRS Subject Level Exam board Date of exam
M M M M M M M M M M M M M M M M M M M M Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y
Predicted grade
Actual grade
All International students should enclose certified copies of their certificates/qualifications with their application.
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Relevant means offences against a person, whether of a violent or sexual nature and convictions involving unlawful supplying of or possession of controlled drugs or substances. Declaring a conviction will not necessarily prevent you from being offered a place at College but failure to disclose something which we later become aware of could result in disciplinary action. Please note that some of our courses, such as care, childcare or health studies, require you to disclose spent and unspent convictions, as well as cautions, reprimands and final warnings in the context of legislation on safeguarding children and vulnerable adults.
Signature of applicant:
Date:
Referees details:
Average Unsatisfactory
Name:
Poor
Position:
Organisation:
Relationship to applicant:
Telephone:
E-mail address:
Please complete all the sections that are relevant to your knowledge of the applicant.
Subjects
Level Grade Actual Predicted
a) ESOL support
Yes o No o Comments
b) Dyslexia support
Yes o No o Comments
Yes o No o Comments
Please return completed application form and reference form to:
e) Disability support
Yes o No o Comments
Course Information Centre Westminster Kingsway College, St Jamess Park Centre, Castle Lane, London SW1E 6DR