Application Form 2022

I wish to apply for the following course(s).

Enrollment Period
Weekday Class: Term February May July October Year
Saturday Class: Term February July Year
Please select (tick) the programme in which you intend to enrol.
Note: Class groups are filled automatically as applicants course fees are paid in full. Once a class is filled, students will be placed on a waiting list.

Classic Cycle Programme

Certificate Programmes
Cuisine Tuition Fee:
Basic Cuisine (180 hours) THB 247,200
Intermediate Cuisine (180 hours) THB 247,200
Superior Cuisine (180 hours) THB 250,000

Pâtisserie Tuition Fee:

Basic Pâtisserie (180 hours) THB 247,200
Intermediate Pâtisserie (180 hours) THB 247,200
Superior Pâtisserie (180 hours) THB 250,000

Diploma Programmes Tuition Fee: Scholarship:

Diplôme de Cuisine (540 hours) THB 744,400 THB 707,180
Diplôme de Pâtisserie (540 hours) THB 744,400 THB 707,180
Grand Diplôme (1080 hours) THB 1,488,800 THB 1,339,920

The Art of Bakery Programme

The Art of Bakery Programme (240 hours) THB 270,000

Professional Thai Cuisine Programme

Thai Cuisine Programme (540 hours) THB 455,000

Remarks:
• The tuition fees shown above are exclusive of the following fees*:
- An application fee THB 5,000
- Uniform THB 9,500 for Weekday students / THB 6,000 for Saturday students
- Tool kit THB 55,000
* These amounts are required for first time enrolment.
• Total tuition & other fees:
- Cuisine/Pâtisserie: Basic Level Certificate THB 316,700 for Weekday students
- Cuisine/Pâtisserie: Basic Level Certificate THB 313,200 for Saturday students
- Cuisine/Pâtisserie: Diplôme Programme THB 813,900 for Weekday students / THB 776,680 for receive scholarship 5%
- Cuisine/Pâtisserie: Diplôme Programme THB 810,400 for Saturday students / THB 773,180 for receive scholarship 5%
- Cuisine/Pâtisserie: Grand Diplôme THB 1,558,300 / THB 1,409,420 for receive scholarship 10%
- The Art of Bakery Programme THB 284,500
- Professional Thai Cuisine Programme THB 524,500
• A non-refundable THB 5,000 application fee must accompany your application form.
• All tuition fees and other fees are including uniform and tool kit payments must be paid in full by the applicable payment due dates.
• Scholarship applicant must pay tuition fees according to school’s condition.
• All tuition fees and other fees are subject to change on a yearly basis.
• Le Cordon Bleu Dusit reserves the right to make any change in tuition fees, other fees, promotion and condition without prior notice.

page 1 of 8
(updated as 31 / 5 / 2022)
 Student ID
Personal Details The required information marked with * are mandatory
First Name-Surname (Mr./Mrs./Miss) Middle Name
Nickname/Preferred Name * Age
Your preferred name will be reflected on LCBD student ID card
Date of Birth (D) (M) (Y) Country of Birth
Passport No. Occupation

Contact Details
Phone No. Mobile No.* Email Address *
Mailing Address *
City Region Post / Zip Code Country
Permanent Home Address (if different from above) *
City Region Post / Zip Code Country
Address in Thailand while you are studing at LCBD
City Region Post / Zip Code

Education
Are you a native speaker of English? yes no
Have you passed an English Proficiency Test? yes no IELTS score: TOEFL score:

Awards / Qualifications Name of Institutions Country Undertaken Month / Year of Graduation

Certified document yes no

Medical Conditions Please provide details of any medical conditions or learning difficulties you may have so that we may assist you during your studies.

Food Allergy and Special Dietary Restrictions please check if any of the following(s) that apply to you:
No Dietary Restrictions
I do not eat ……........................................................................................................................................... due to religious/belief reason
I have food allergies/dietary restrictions (please specify) ……..................................................................................................................

Financial Sponsor * (required by the Thai Ministry of Education - MOE)

Expenses per month during the course (Thai Baht):
Name Surname Relationship
Address Post / Zip Code
Phone No. Mobile No. Email Address

Family Information Details * (required by the Thai Ministry of Education - MOE)

Father’s Name Surname
Occupation
Mother’s Name Surname
Occupation

page 2 of 8
(updated as 31 / 5 / 2022)
Emergency Contact person *
Name Surname Relationship
Address Post / Zip Code
Phone No. Mobile No. Email Address
How did you hear about the programme(s) at LCBD? (you can select more than one answer)
Friends/Relatives School Other websites Other campus of LCB Schools
LCBD Alumni Magazine Television, which TV programme? ..........................................
Newsletter Exhibitions Educational Agent LINE Official
Facebook Instagram Other (please specify) .....................................

Why did you choose LCBD? (please rank in order of importance: 1=very important, 2=important, 3=less important)
Quality Location Reputation Price Language Programme Length
Received Scholarship Transfer from other LCB schools Sponsor’s recommendation
Application Procedures
For efficient processing of your application please ensure that you have provided all relevant documents below:-
A copy of your passport
An entry stamps to Thailand in every pages (During the last 2 years)
Education certificate / diploma or equivalent qualification
Academic transcript (certified copies required)
Letter of Motivation form
Medical certificate (in case of any medical conditions or learning difficulties)
18 colour photographs (size 4x6 cm) for International students
THB 5,000.- non-refundable application fee (To be made upon submitting the application form*)
Remark: • All documents must be translated into English.
• Please ensure that your name printed on the passport is exactly the same in other required documents.
• Payment may be made by any of the methods listed in the Payment Methods.*

Visa Assistance Information

Do you need to apply for a “Non-Immigrant ED” student visa?
No If not what type of visa will you be holding during your study?,
Non “O” Non “B” Tourist
Other, type of visa Valid from (D) (M) (Y) Valid until (D) (M) (Y)

Yes If yes, please provide the following information.

Please specify the ‘Thai Consulate’ or the ‘Royal Thai Embassy’ where you will apply for your visa:
City / Town Country
Have you been to Thailand during the last 2 years?
no yes If yes, please answer the next questions.
How many times have you visited Thailand?
1 time 2 times 3 times more than 3 times Last entry to Thailand was in year
How long did you stay during your last visit? Please specify the visit dates.
1. From (date) To (date) Visa type
1. From (date) To (date) Visa type
1. From (date) To (date) Visa type
page 3 of 8
(updated as 31 / 5 / 2022)
 Student Uniform

Please select the correct size from the tables below or if you have special requirements,
please specify in the special measurement section below:-

Chef Jacket: Size SS S M L XL 2XL 3XL 4XL 5XL

special measurement
Trousers: Size SS S M L XL XXL 3XL 4XL 5XL
special measurement
Chef Hat: Size S M L

Standard Size: Chef Jacket Standard Size: Trousers (Elastic Waist) Standard Size: Chef Hat
SS Chest 38”/ Hip 38” SS Waistline 26-32“/ Hip 38” S Circumference 21”
S Chest 40”/ Hip 40” S Waistline 28-34“/ Hip 40” M Circumference 23”
M Chest 42”/ Hip 42” M Waistline 30-36“/ Hip 42” L Circumference 24”
L Chest 44”/ Hip 44” L Waistline 32-38“/ Hip 44”
XL Chest 46”/ Hip 46” XL Waistline 34-40“/ Hip 46”
2XL Chest 48”/ Hip 48” XXL Waistline 36-40”/ Hip 48”
3XL Chest 50”/ Hip 50” 3XL Waistline 40-46“/ Hip 52”
4XL Chest 55”/ Hip 55” 4XL Waistline 44-50“/ Hip 56”
5XL Chest 59”/ Hip 59” 5XL Waistline 48-52”/ Hip 60”
Circumference
Special Measurement
Request Section
Armhole Chef jacket
Shoulder
Shoulder ......................... inches
Chest
Chest .............................. inches
Waistline Armhole .......................... inches
Hip Pants
rise
Trousers
Around
top of thigh Waistline ........................ inches
Length Hip .................................. inches
Length ............................ inches
Pants rise ........................ inches
Around top of thigh ........... inches

Important Notice
The sizes on the clothing market are standardized. Therefore, the correct measurement in inches must be given to us.
The school shall not be held responsible for wrong measurements. Any claim following the wrong provision of measurements
for the uniform will not be considered. Your uniform will only be made after we receive your payment.

page 4 of 8
(updated as 31 / 5 / 2022)
 Payment Methods

Payment Methods: Application Fee

1. Payment by Credit Card

Le Cordon Bleu Dusit accepts credit card payment at the school and school website for application fee without processing fee.
School will be charge processing fee 3% on top if you are filling payment form.
2. Payment by Bank Transfer
Le Cordon Bleu Dusit accepts transfer payment to school account (Bangkok Bank). Payment by bank transfer can be made to
the bank details below.
Notes: Students are required to pay all bank fees incurred when transferring money from a foreign country.

Payment Methods: Tuition Fee

1. Payment by Credit Card

Le Cordon Bleu Dusit accepts Visa and Master Card for payment of certain fees.
• 0% for Visa and Master card when making a payment at the school for installment programme
• 1.5% for Visa and Master card when making a payment at the school
• 3% for filling payment form
Notes: - Payment by credit card will incur a surcharge.
- Installment programme 0% 4 or 10 months is available for Classic Cycle, Professional Thai Cuisine and The Art of Bakery programme only.

2. Payment by Bank Transfer

When depositing tuition fees into the bank account, please email a copy of the bank receipt to [email protected]
All payments must be accompanied by the student’s name and the student’s programme of study. This aids in prompt processing of
payment and prompt issuing of the Confirmation of Enrolment Package (COE).

Account Name : Le Cordon Bleu Dusit Co., Ltd. Bank Name : Bangkok Bank Public Co., Ltd. / Zuellig House Branch
Account No. : 860-3-00232-3 (Current Account) Bank Address : 1 Zuellig House, Silom Rd., Bangrak, Bangkok 10500
Swift Code : BKKBTHBK

Admission Procedures

Assessment and Availability

Upon receipt of the completed application form and supporting documentation, Le Cordon Bleu Dusit assesses the application
to determine if all entry requirements have been met and ensures availability of places in the course(s) chosen.
Letter of offer
If the application is successful, Le Cordon Bleu Dusit issues a “Letter of Offer” for a place in the nominated course.
The “Letter of Offer” pack is sent to each applicant or their education agent.
Prior to acceptance and first payment
Overseas students intending to accept the offer must complete the “Personal History Check” and “ Purpose of Attending the Course”
by signing the forms and returning them to Le Cordon Bleu Dusit for the Pre-Approval Letter from the Ministry of Education, Thailand.
Payment of tuition fee(s), the uniform and the tool kit must be paid and proof of payment must accompany the returning of the letters.
Confirmation of Enrollment (COE)
After receipt of the two letters and the payment of all fees, Le Cordon Bleu Dusit will issue a Confirmation of Enrollment (COE including
the Pre-Approval Letter and the Letter for the Thai Embassy, the School Registration Letter, and the payment receipt.
Application for Visa
Overseas students must submit the COE package to the Thai Embassy/Thai Consulate in their country for an education visa.
page 5 of 8
(updated as 31 / 5 / 2022)
 Fees, Conditions & Refunds Policy
1. A non refundable Application Fee is payable upon you will not be entitled to any other option mentioned 18. If a student fails or is unable to complete a course
application for enrolment or re-enrolment. in the refund policy. Every reasonable effort will be made due to a default by Le Cordon Bleu Dusit Culinary School,
to accommodate the applicant on a later course of being the failure to start the course on the agreed
2. If Le Cordon Bleu Dusit Culinary School does not his/her choice. If the tuition fee for the course to be starting date, the course ceasing after it starts and
accept an application for any reason or the student VISA attended is greater than that of the course originally before it is completed, the student shall be entitled to a
is refused, there will be no refund of the application fee. selected, the applicant shall pay the balance in cleared pro-rata refund of the administration and tuition fees.
funds to Le Cordon Bleu Dusit Culinary School within The amount of the refund will be paid within 4 weeks
3. Le Cordon Bleu Dusit Culinary School will not accept a designated time frame. of the date of default and shall be accompanied by a written
the tuition fee if a place is not available for the intake statement setting out how the amount has been calculated.
applied for, and will consult with the student to defer 8. An application fee must be reprocessed which subjected
commencement date. to the conditions; when the deferment of the programme 19. All students are bound to comply with the rules and
is over 12 months, or students who have not previously regulations stated in the Le Cordon Bleu Dusit Culinary
4. New students must submit full tuition fees, toolkit, and started a long-term programme with Le Cordon Bleu Dusit School’s Student Handbook.
uniform payments on the day of the deadline or at least Culinary School and request a tuition fee refund.
6 weeks before course commencement. Students may 20. Le Cordon Bleu Dusit shall be under no liability
choose to pay a course in installments by consulting with 9. Le Cordon Bleu Dusit Culinary School reserves the right whatsoever to any student for any loss or damage and
Student Services Department for a “Partial Payment/ to review administration and tuition fees at any time. personal injury or death caused by negligent act or
Installment Registration Form”; as an international student If administration and tuition fees are increased, the students omission of any student sustained at or upon the School’s
must pay a minimum of 50% of the tuition fee along will be required to pay the new rate as they are introduced. permises, except for personal injury or death caused by
with uniform and toolkit fees on or before the enrolment Le Cordon Bleu Dusit Culinary School, its employees,
deadline set by the school. Any overdue balance must be 10. Tuition fees do not include uniforms or equipment. agents or servants or any other person concerned,
settled before the term starts and must be made at least All uniform alteration costs will be the responsibility of whether in respect of an negligent act or omission,
10 days before the Orientation Day, otherwise students the student. within such premises.
will NOT be allowed to commence their studies. 11. All additional requests for original Academic Transcripts 21. Le Cordon Bleu Dusit Culinary School reserves the
All payments must be made by bank transfer or credit will incur a charge of 500 Baht per copy or 1,000-1,500 Baht right in its absolute discretion to review and alter the
cards Visa / Master card in (Thai Baht only). for each additional Le Cordon Bleu Dusit Culinary School organization and/or structure of the course at any time.
parchment (1,000 Baht for Basic-Intermediate-Superior Cuisine 22. If any material alteration is made before the
5. Le Cordon Bleu Dusit Culinary School reserves the right / Patisserie programme and 1,500 Baht for Diplome de Cuisine,
to charge a late payment fee 5% of the course tuition fee, Diplome de Patisserie, Diplome de Cuisine Thai, Diplome de commencement of a course, Le Cordon Bleu Dusit
if the payment is not received by the due date. Boulangerie and Grand Diplome). Culinary School will endeavor to notify any student who
affected, but shall not have any liability if it is unable
6. An applicant who has been accepted for an enrolment by 12. No refunds will be made for changes of a student to notify.
Le Cordon Bleu Dusit for a particular term but who then VISA or for VISA cancellation.
decides not to start the course and who provides formal 23. Le Cordon Bleu Dusit Culinary School covers only
written notice to LCBD, shall be entitled to a refund. 13. Credit card holder of Visa or Master card will be subject the accidental insurance during the period of student’s
Please see the chart below what % of the tuition fees to bank surcharge. Other cards are not accepted. enrollment.
will be refunded. 24. Le Cordon Bleu Dusit Culinary School reserves the
14. All bank fees and charges shall be borne by the student.
% of the Tuition Fees
to be Refunded Effective Date of Refund Request right and liberty to use promotional work taken in the
15. Any student refusing to pay administration and / or form of photography, films or reproductions for the
100% More than 30 days before the classes start tuition fees after requests have been made in writing purpose of advertising, photography and publicity – either
90% More than 30 days before the classes start* shall not receive any form of award or recognition of wholly or partially, in any manner or form whatsoever and
courses undertaken and shall be refused entry into class in any medium, either separately or in conjunction with
85% Between 14-30 days before the classes start until the outstanding fees have been remitted to other photographs, films or reproductions there of,
Le Cordon Bleu Dusit Culinary School in full. Le Cordon including the works produced by students.
50% Between 7-14 days before the classes start Bleu Dusit Culinary School will also pass on any charges 25. No student shall be entitled to use the names
incurred to collect outstanding monies. “Le Cordon Bleu”, “Le Cordon Bleu Dusit Culinary School
0% Less than 7 days before the classes start
16. Le Cordon Bleu Dusit Culinary School reserves the or “Dusit” under any circumstances or at any time or
* for installment programme 0% 4 months or 10 months only in any place whatsoever, whether before, during or after
Please note that the application fee is non-refundable. right at its absolute discretion to reject any application of their training and whether as a trade mark, company
enrolment, and it shall be under no obligation whatsoever or trading name or otherwise, regardless of the service
7. An applicant whose application has been accepted to give reasons for the school's decision. or products presented with no time or geographical
may defer his / her commencement only 1 time of the course limitation.
to a later term within 12-month period. All applications for 17. If a student fails to complete a course for any reason 26. This policy is correct at time of printing, but subjected
deferment must be received by Le Cordon Bleu Dusit other than the default of Le Cordon Bleu Dusit Culinary School, to change without notice.
Culinary School no later than 2 weeks before the course there will be no refund of paid administration or tuition fees
commencement. Once this choice is taken by a student or reduction in paid payable.

Le Cordon Bleu’s Intellectual Property

Please read this section carefully.

Le Cordon Bleu vigorously defends its trade marks, copyright materials and other intellectual property rights and will take action to preventany breach of its rights,
including by claiming financial compensation.
In this section “you” and “your” refer to the student making this application but its terms apply both during and after your studies at the Le Cordon Bleu institute.
Trade Marks
Le Cordon Bleu International is the owner of a number of trademarks registered in numerous countries throughout the world for many classes of services and products, which include notable
“Le Cordon Bleu”, the Le Cordon Bleu logo (which appears on the top of this application form) and “Grand Diplôme”.
You must not use any of Le Cordon Bleu’s trade marks, or any confusingly similar trade mark, in connection with any activity that is commercial, business-related or professional in its nature or
purpose. By way of example, such prohibited use would include use as or as part of a company name, trading name, domain name or email address.
Uniforms
After your studies we hope that you will keep and treasure your Le Cordon Bleu uniform and you are, naturally, free to use it in a purely private and non-commercial context.
However, please note that you must not wear any part of the Le Cordon Bleu uniform or any other clothing that bears any of Le Cordon Bleu’s trade marks in connection with any activity that is
commercial, business-related or professional in its nature or purpose.
Le Cordon Bleu will take firm action to prevent any misuse of the uniform.
Copyright Materials
The copyright in all learning, pedagogical and other materials provided to you by Le Cordon Bleu during your studies is owned by Le Cordon Bleu International, except for any materials which
may be in the public domain and materials used by permission of a third-party copyright owner.
Such materials are provided for your personal educational use only and must not be reproduced, distributed or shared with others except with the prior written permission of the Institute’s senior
management.
By signing this Application Form you accept the above.
page 6 of 8
(updated as 31 / 5 / 2022)
 This section for Education Agent Staff only
Education Agent Name please stamp company logo here
Contact Person
Address
Post Code Country
Phone No. Fax No.
Mobile No. Email Address

I acknowledge that all the information provided on this form is correct and I hereby declare to abide by the terms and conditions in the Fees, Conditions and Refunds Policy.
I agree to be bound by Le Cordon Bleu Dusit rules and regulations and acknowledge that all disputes arising from the details and conditions contained in the application
shall be governed by and constructed in accordance with the laws of the Kingdom of Thailand and be submitted to the jurisdiction of the courts of Thailand.
I understand that the information provided by me to the School may be made available to MOE as well as to the Immigration Authorities in Thailand. Please sign below.

Name of Student Signature Date

Name of the Parent / Legal Guardian (Age below 20 years old) Signature Date

Photograph, Video or Audio Recording Consent and Release Form

Without expectation of compensation

Without expectation or other remuneration,
of compensation now or in thenow
or other remuneration, future,
or in the future,

I, ____________________________________________________ hereby give hereby

I, ____________________________________________________ my consent to Leconsent
give my CordontoBleu Dusit Culinary
Le Cordon School,
Bleu Dusit its affiliates
Culinary School, and
its affiliates and
agents, to use my image
agents, to useand
mylikeness and/or
image and any interview
likeness and/or anystatements
interview from me in itsfrom
statements publications, advertising oradvertising
me in its publications, other media activities
or other media activities
(including the(including
Internet).theThis consent includes, but is not limited to:
Internet). This consent includes, but is not limited to:
(a) Permission
(a)toPermission
interview,tofilm, photograph,
interview, tape, or otherwise
film, photograph, tape, ormake a videomake
otherwise reproduction of me and/orofrecord
a video reproduction my voice;
me and/or record my voice;
(b) Permission
(b)toPermission
use my name;
to useandmy name; and
(c) Permission
(c) toPermission
use quotes fromquotes
to use the interview(s) (or excerpts
from the interview(s) (orofexcerpts
such quotes),
of such the film, the
quotes), photograph(s), tape(s) tape(s)
film, photograph(s), or or reproduction(s)
reproduction(s) of me,
of me, and/or
and/or recording
recording of myofvoice,
my voice,
in partinorpart or in whole,
in whole, in its publications,
in its publications, in newspapers,
in newspapers, magazines
magazines andprint
and other other print on television,
media,
media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for
radio and electronic media (including the Internet), in theatrical media and/or in mailings for educational and publicity educational andpurpose.
publicity purpose.

This consentThis
is given in perpetuity,
consent is given inand does notand
perpetuity, require
does prior approval
not require by approval
prior me and can be used
by me untilbefurther
and can noticefurther
used until from Le Cordon
notice fromBleu
Le Cordon Bleu
Dusit Culinary School.
Dusit Culinary School.

Signature: ___________________________________________________________________________________________________________
Signature: ___________________________________________________________________________________________________________

Date of Birth:Date of Birth: ________________________________________________________________________________________________________

________________________________________________________________________________________________________

Date: ________________________________________________________________________________________________________________
Date: ________________________________________________________________________________________________________________

It is understood that this material will be used in a legitimate manner, both internally and outside Le Cordon Bleu Dusit and is not
intended to cause any harm or undue embarrassment to the parties involved.

Date Mr. Michel Peters – Joint Venture Director

page 7 of 8
(updated as 31 / 5 / 2022)
 Letter of Motivation

Please fill in your motivation statement of at least 300-500 words in English or Thai language only.

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

…………………………………………………………………………………………………………………………………………………….

page 8 of 8
(updated as 31 / 5 / 2022)