FoundationApplicationForm.docVIP

Date received Student numberLanguage Centre 30/32 Tyndall’s Park Road, Bristol BS8 1PY, UK Telephone: +44 (0)117 3310909 Fax: +44 (0) 117 3310870 Email: Language-Centre@bris.ac.uk Website:  HYPERLINK http://www.bris.ac.uk/Depts/LangCent www.bris.ac.uk/languagecentre   APPLICATION FORM INTERNATIONAL FOUNDATION PROGRAMME – PATHWAY CERTIFICATE IN FOUNDATION STUDIES 2010/2011 Please complete all pages in BLOCK LETTERS. COURSE DETAILS I wish to apply for a place on the following International Foundation Programme variant: English for Academic Purposes 04 October 2010 – 24 June 2011 English with Arts and Humanities 04 October 2010 – 24 June 2011 English with Mathematics 04 October 2010 – 24 June 2011 English with Physics and Mathematics 04 October 2010 – 24 June 2011 English with Economics and Finance 04 October 2010 – 24 June 2011 English with Chemistry and Mathematics 04 October 2010 – 24 June 2011 (tick box)  PERSONAL DETAILS Please attach a passport-sized photograph Family Name: First Name (s): Title: Male/Female:  Date of Birth (dd/mm/yyyy): Age on 1st October 2010: Nationality: Country of Residence: Mother Tongue: Email Address: Telephone: Fax:  Home Address: (Please complete this section accurately and include the student’s personal email address. This is essential for Visa and registration purposes): Personal Email Address (if different from above):  Address for correspondence (if different from above): Education and Career Please give details of your Secondary and University Education (as appropriate): School/College/UniversityFromToPart/Full Time   Highest level of academic or professional qualification obtained to date, or expected to be obtained by October 2010. (tick box)ObtainedExpected___________________________________________________________________________ Please enclose an academic transc