SECTION 1. PERSONAL DETAILS
Title: *
Title Mr Mrs Ms Miss Other for Mr John Robert Kennedy:
Gender: *
M/F Male Female
First name: *
John
Date of Birth : *
dd12345678910111213141516171819202122232425262728293031
mm123456789101112
yyyy194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002
Middle Name:
Robert
Your Passport No:
(If known):
Last Name: *
Kennedy
Your Nationality: *
Contacts: Please note that these details must be current so that we can reach you without problems or unnecessary delays.
Home Address: (Must be Student's - NOT Agent's)
Correspondence Address: (To Send Your Offer Letter)
Address Line 1: *
32 Den Road
Address Line 2: *
Village/City??
Address Line 3:
District?
Country: *
State/Province: *
Home/City: *
Post/Zip Code: *
PU2 3HR
Tel: (To call you) *
Tel (UK):
Mobile:
Mobile (UK):
Fax:
Email: *
SECTION 2. COURSE DETAILS
Course Title: *
----- Select -----Certificate in ITPostgraduate Diploma in Business ManagementPostgraduate Diploma in Business Management leading to MBADiploma in ITProfessional Graduate Diploma in ITCertificate in Administrative ManagementDiploma in Administrative ManagementAdvanced Diploma in Administrative ManagementMBA Top upNational Extended Diploma in Health, Social Care & Early YearsESOL InternationalInternational Diploma in Travel and TourismDiploma in CriminologyAssociation of Chartered Certified Accountants
Course Code:
(If known)
For Intake: *
To Start : *
(If known))
Study Mode:
Part Time Full Time (Overseas students must select Full Time!)
Fee Status:
Overseas UK
Write here your aims and reasons for choosing this course.
SECTION 3. EDUCATION/TRAINING AND QUALIFICATIONS TO DATE (evidence will be required!)
EDUCATIONAL ACHIEVEMENTS
Start dd-mm-yyyy
End dd-mm-yyyy
Level/Programmes/Subjects
e.g.MCSE, ICDL, NCC
Awarding Body
e.g. WAEC, Oxford
Grades/Results
Date of Award
e.g.mm-yyyy
1.
2.
3.
PROFESSIONAL TRAINING
Level/Programmes
e.g. MCSE, ICDL, NCC
EMPLOYMENT HISTORY AND ACHIEVEMENTS
Employer
Place
Position Held
Brief Comments
REFERENCES (Please provide us with the current details of two referees - one of them has to be your current employer or the head of your last institution attended. Note: Queensbury College London reserves the right to reject an application if the given referees are not reachable)
No.
Name of the Referee
Address
Designation
Telephone/Fax
Email
1. * Academic
SECTION 4. Upload Documents
SECTION 5. STUDENT SURVEY
QUESTIONNAIRE (Please note that the College uses information in this section to support its Equal Opportunity Policy and to improve the standards of student services)
1. What do you consider your ethnic origin? (e.g. Asian Indian, White English, African Black etc)
2. How did you hear about us? (e.g. Agents, Search Engine Google/yahoo, Newspaper)
-- Select --Asian - AfghaniAsian - BangladeshiAsian - IndianAsian - NepaliAsian - PakistaniAsian - Sri LankanBlack AfricanBritishChinise
-- Select --AgentFriendGoogle Search EngineLocal News papersNewspaperWeb
3. How do you plan to fund your studies?
Are you ready to make the minimum payment required?
5. If yes, do you require special documentations for visa application as directed by your local British Consulate or Embassy in addition to the regular formality documents? Please explain.
6.Have you successfully completed an English test such as IELTS, TOEFL, EFL or ESOL? Enter the grades below:
IELTS Score: TOEFL Score: EFL Results: Cambridge ESOL Results:
SECTION 6. PERSONAL STATEMENT (OPTIONAL!)
Make your case! (This section is optional!)
Please tell us why you have chosen the programme/courses if you think it would strengthen your case for admission. Maximum 150 words!
SECTION 7. DECLARATION (Must be completed and signed by the applicant!)
Read before you sign! *
I declare hereby that the information I have given in this form is correct to the best of my knowledge and I bear full responsibility for its accuracy. I have read and agreed with the Terms and Conditions of Applications given in Section 8 of this form.
SECTION 8. SUBMISSION
Ready to submit? (Please look and tick through the checklist below to see if you have correctly completed these and are ready to submit)
Filled all Sections?
Check this if you agree for us to correspond with you in future regarding our offers and news
Please note that by clicking the SUBMIT button you agree to the Terms and Conditions of Application as outlined in Section 8 and the related College Rules enforcing these conditions. Declaration must be checked above for a valid submission.
CONTACT US (CLICK HERE FOR DETAILS)