INTERNATIONAL STUDENTS
English Language Programmes
Enrolment Form 2016-17
CHOOSE A PROGRAMME
General English (All year).................................................................................................................................................................................................
General English with IELTS Preparation (All year).............................................................................................................................................................
CHOOSE YOUR DATES
From: ....................................................................... e.g.: 04 January 2017
To: ..................................................................................... e.g.: 13 June 2017
PERSONAL DETAILS
Title: Mr/Mrs/Ms/Miss...........................
Family name:....................................................................................................................................................
Other names:...................................................................................................................................................................................................................
Address:...........................................................................................................................................................................................................................
City: ....................................................................... Postcode: .................................. Country: ....................................................................................
Tel No. (Include International Code): ............................................................................. Mobile No.: ...............................................................................
E-Mail: .............................................................................................................................................................................................................................
Nationality: .............................................................................................
Mother tongue: ..........................................................................................
Date of birth: day.................... month................... year......................
Male
Female
Occupation:.....................................................................................................................................................................................................................
Age at beginning of programme:...................................................................................................................................................................................
What is your current level of English?
Elementary
Have you taken an English test in the past 2 years?
Lower Intermediate
Yes
Intermediate
Upper Intermediate
Advanced
No
If ‘Yes’, which test?(Please supply us with a copy of your certificate):
Date of test: ............................................................................................................ Score: ..........................................................................................
www.canterbury.ac.uk\general-english
INTERNATIONAL STUDENTS
YOUR STUDY DETAILS
Are you continuing onto an undergraduate or postgraduate programme after finishing your English programme?
Yes
No
If ‘Yes’ please name the programme and the name of the College/University: ....................................................................................................................
.........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................
Have you studied or are you now studying English in the UK? Please give the name of the institution, the start and finish dates of your course and
the type of course you have attended:
.........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................
Why do you wish to study English? ...............................................................................................................................................................................
.........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................
PASSPORT AND VISA DETAILS
Do you already have a visa to live or study in the UK?
Yes
No
If yes, please provide us with a copy of your visa
Passport number:.............................................................................................................................................................................................................
Please provide us with a copy of the personal details page of your passport with this application
OTHER INFORMATION
How did you hear about Canterbury Christ Church University’s English Language Programme?
Agent
Internet
Advertisement
Family/Friend
Exhibition
Other
Please give us further information and the name of your agent?..................................................................................................................................
.........................................................................................................................................................................................................................................
.........................................................................................................................................................................................................................................
Do you have any special needs – e.g. illnesses / medication / allergies?
Yes
No
If ‘Yes’, please provide us with any details you feel we should know that may require support during your studies with us?
www.canterbury.ac.uk\general-english
INTERNATIONAL STUDENTS
PAYMENT/SPONSORSHIP
Once you receive an offer to join our course, you will be sent a Conditional Offer requesting payment. Details of how to make payment will be set out in
this letter.
Will you be paying for your course personally?
Yes
No
If ‘No’, please provide details of your sponsor (employer or government) who will be responsible for paying your fees:
ACCOMMODATION
Do you require accommodation?
Yes
No
1st Choice
Homestay accommodation
1.
And tick the type of plan:
2nd Choice
Homestay accommodation
1.
And tick the type of plan:
Bed & Breakfast - £112 p.w.
Bed & Breakfast - £112 p.w.
Bed & Breakfast with use of Kitchen - £117 p.w.
Bed & Breakfast with use of Kitchen - £117 p.w.
Half-board - £156 p.w.
Half-board - £156 p.w.
Half-board with weekend lunch - £181 p.w.
Half-board with weekend lunch - £181 p.w.
2.
University residence - academic year 2017
2.
University residence - academic year 2017
Non-ensuite (shared kitchen & bathroom facilities) £145 p.w
Ensuite (individual bathroom & shared kitchen facilities) £165 p.w
Non-ensuite (shared kitchen & bathroom facilities) £145 p.w
Ensuite (individual bathroom & shared kitchen facilities) £165 p.w
(Parham Road - single ensuite) or £190 p.w (Petros Court - large ensuite)
(Parham Road - single ensuite) or £190 p.w (Petros Court - large ensuite)
(Free internet included, kitchen pack & bed bale included)
(Free internet included, kitchen pack & bed bale included)
3.
University residence - Summer School 2017
(please inquire for confirmation of costs)
3.
Non-ensuite (shared kitchen & bathroom facilities)
Ensuite (individual bathroom & shared kitchen facilities)
Non-ensuite (shared kitchen & bathroom facilities)
Free internet included, kitchen utensils & bed bale included
Ensuite (individual bathroom & shared kitchen facilities)
University residence academic year and Summer School subject
to availability - rooms are allocated on a first-come, first-served basis)
Free internet included, kitchen utensils & bed bale included
University residence academic year and Summer School subject
to availability - rooms are allocated on a first-come, first-served basis)
University residence - Summer School 2017
(please inquire for confirmation of costs)
Single sex accommodation required
Do you have any Disabilities, special requirements, preferences or other information relevant to the booking including dietary requirements:
Yes
No
If Yes, please complete the additional Confidential Medical Questionnaire.
www.canterbury.ac.uk\general-english
INTERNATIONAL STUDENTS
DECLARATION
If I am accepted as a student of Canterbury Christ Church University, I agree to abide by the University and UKBA rules, to attend classes and pay fees when
due. I have checked the UKVI website regarding my eligibility to a visa to enter the UK.
(details can be found at: www.ukba.homeoffice.gov.uk/studyingintheuk)
I understand that the deposit cannot be refunded after the beginning of my programme, unless there are exceptional circumstances.
I understand I will not be able to begin a programme of study at CCCU before I have paid the initial fee (deposit) indicated in my offer letter or provided
confirmation of my sponsorship if applicable.
Refund Policy:
The deposit will be fully refunded if I am not able to get a visa / entry clearance and I you send you a copy of the visa refusal letter from the British Embassy
/ Consulate prior to the start of my course.
I confirm that to the best of my knowledge information and belief the information I have provided on this application form is accurate and complete.
Signature of Applicant ......................................................................................................................................................................................................
Date..................................................................................................................................................................................................................................
Once completed, please return this form either by post or email to:
Post: The International Office
Canterbury Christ Church University
Canterbury
Kent
CT1 1QU
Email: [email protected]
120/JN/0516
www.canterbury.ac.uk\general-english