Date of birth (DD/MM/YYYY)*
Student Email Address*
Please indicate below any medical condition you wish the College to be made aware of:
Do you consider yourself to have a disability or learning difficulty*?
Was English the language of instruction in your previous institution*? Yes No
If Yes, what is the number of years you have been taught in English?
Enter relevant grade (e.g. 5.5):
Date taken (DD/MM/YYYY)
Other English qualifications and grade
I do not have an English qualification yet
Exam to be taken (DD/MM/YYYY)
Relationship to student*
Do you intend to submit an OEA application? Yes No
Who will be paying for your course?The person named above under 5. below
Relationship to student
All courses are £7000 GBP per year.
A deposit of £1000 GBP must be paid to secure the place and the balance of £6000 GBP is payable before the start of the course in September. Non payment will result in withdrawal from the course.
In order to help identify your payment, please quote the student’s name and date of birth when making a bank transfer. Please ensure that the college receives the EXACT sterling amount allowing for all bank charges. Please note that we do not accept payment online or via credit or debit cards.
Name of Agency
By signing this form below, I confirm that the information given on this form is correct and complete and agree to the processing of such data for any purpose connected with the application or future studies.I / We have read the terms and conditions of payment and admission and accept them.I / We acknowledge responsibility for the application and fees of the above named student.
Please enter your full name to sign this form
Parent / Guardian*
Please enter any additional information (optional):
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