Address

Current Address:

Postcode:

Tel (Home):

Tel (Mobile):

E-mail:

Overseas Address (if applicable):

Postcode:

Tel (Home):

Tel (Mobile):

E-mail:

Date of Entry to UK (if applicable):

Proposed Course: e.g (English Language, HND, etc)

Mode of Study: Select Here Full Time Part Time Distance Learning

Commencement Date:

Educational Qualifications

Please attach the relevant certified copies of educational certificates.

Examinations for which you are awaiting results:

English Language Competence:(students eduacted outside the UK should enclose copies of their English Language qualifications.)

A) Is English your first Language?

Yes
No

B) Have you taken any English Language proficiency test?

Yes
No

If yes please attach a copy of the certificate.

What are your resasons for applying to register for this qualification?

Monitoring Information

Whitechapel College is commited to a policy of equal opportunities. In order to monitor the effectiveness of this policy applicants are asked to complete this monitoring form. These statistics are used solely for the purpose of monitoring application rates and form no part of the selection procedure.

Do you have any criminal convictions, either abroad or in the UK?

Yes
No

You are required to state whether or not you have any criminal convictions, excluding motoring offences for which a fine and/or up to three penalty points were imposed. If you tick the 'yes' box, you may be required to provide the details of any convictions below:

Please tick the box which you feel describes your ethnic origin
Black - Carribbean
Black - Other
Asian - Indian
Asian - Pakistani
Asian - Bangladeshi
Asian - Chinese
Asian - Other
White
Any other ethnic group (Please specify) :

Disability/ Special Needs. (Please Tick the box which you feel appropriate to you)

None.

You do not have a disability nor are you aware of any additional support requirements in study or accomodation.

You have dyslexia.

You are blind/partially sighted.

Your are deaf/have a hearing impairment.

You are a wheelchair user or have difficulties with mobility.

You need personal care support.

You have mental health difficulties.

You have an unseen disability.

You have two or more of the above disabilities/special needs.

You have a disability not listed above.

Please Specify:

Referee

Name and Address of Referee.

Name:

Address:

Tel (Home):

Tel (Mobile):

E-mail:

Employment History

Additional Information: (you may write anything here you like if you think we have not asked you or you think that something additional is needed)

Payment of Tution Fees

Fees can be paid by bank draft, cheque, bank transfer or cash in pounds sterling. Cheques and drafts should be made payable to Whitechapel College.

Terms and Conditions

No student will be admitted to any programme unless the Director of Admissions is satisfied that their previous qualifications will enable them to benefit from the proposed programme.

i. The registration fee of £100 is non-refundable.

ii. It is a condition that the College requires at least 80% attendance from a student before examination. In the event of a student being expelled by the College, no fee will be refunded.

iii. If a student decides to withdraw, he/she can apply for partial refund of the paid up tution fees but only if he/she has not attended the classes for his/her course. No fees will be refunded if he/she has attended any classes.

iv. Any prolonged absence from classes must be reported to the Administrative Office immediately. Students must notify any changes of address to the office. Overseas students must note that where a statement has been sent to the Home Office to support visa applications, the College will be obliged to notify the Home Office of any cancellation.

v. The College reserves the right to cancel any course prior to commencement date whereupon any fees paid will be refunded in full.

vi. The College reserves the right to withdraw a subject at any time when it considers that it is not viable, whereupon an alternative subject may be offered.

vii. If any student ceases to study at the College for any reason whatsoever (for example: suspension, expulsion, cancellation of registration) the agreed instalments are still payable by the student for the remaining portion of the academic year at the same dates and times as in the orignal enrolment contract.

viii. Students are not entitled to any refund of the deposit where the enrolment has been supported by a visa letter from High Comissions/Embassies or the Home Office in the UK or any other documentation.

ix. The formation or continuation of any course/class is dependent upon a sufficient number of student enrolments and attendances. For most courses there will be a minimum enrolment of eight students.

x. Students supplying false information on the application form are liable to be suspended from the College.

xi. If the official admission form is signed on behalf of the student by his/her sponsor/guardian, these conditions remain binding on all parties. The College reserves the right to make whatever changes may be deemed necessary in admission requirements, fees, tuition policies, regulations and academic programmes prior to the start of the tution.

Declaration

No application will be considered if this declaration is not signed by the applicant.

I declare that the statement made by me are correct to the best of my knowledge and belief. I have read and understood the College's terms and conditions. I agree to be bound by those terms and conditions. I understand that no refund will be made in the event of cancellation or my non-attendance of the course.

Print Name: Date:

Attach documents below:

1.

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