Application Form

Similar documents
Application for Admission to Postgraduate Studies

. Town of birth. Nationality. address)

International Application Form

Application for Postgraduate Studies (Research)

APPLICATION FOR ADMISSION 20

TESL/TESOL Certification

2. 20 % of available places are awarded to other foreign applicants.

THIRD YEAR ENROLMENT FORM Bachelor of Arts in the Liberal Arts

CONSULTATION ON THE ENGLISH LANGUAGE COMPETENCY STANDARD FOR LICENSED IMMIGRATION ADVISERS

Birmingham City University BA (Hons) Interior Design

Information Pack: Exams Officer. Abbey College Cambridge

Please fill in the application form below if you wish to apply for any of the study programs of the Faculty of Humanities.

Duke University. Trinity College of Arts & Sciences/ Pratt School of Engineering Application for Readmission to Duke

THE UNIVERSITY OF THE WEST INDIES OPEN CAMPUS

DUAL ENROLLMENT ADMISSIONS APPLICATION. You can get anywhere from here.

Accreditation of Prior Experiential and Certificated Learning (APECL) Guidance for Applicants/Students

Exclusions Policy. Policy reviewed: May 2016 Policy review date: May OAT Model Policy

APPLICATION FORM KOI 2013: Training Course Road Safety in Asian & Latin American Countries: Principles and Approaches

Advertisement No. 2/2013

QUEEN S UNIVERSITY BELFAST SCHOOL OF MEDICINE, DENTISTRY AND BIOMEDICAL SCIENCES ADMISSION POLICY STATEMENT FOR DENTISTRY FOR 2016 ENTRY

INSTRUCTIONS FOR COMPLETING THE EAST-WEST CENTER DEGREE FELLOWSHIP APPLICATION FORM

FULBRIGHT MASTER S AND PHD PROGRAM GRANTS APPLICATION FOR STUDY IN THE UNITED STATES

22264VIC Graduate Certificate in Bereavement Counselling and Intervention. Student Application & Agreement Form

SMILE Noyce Scholars Program Application

International Undergraduate Application for Admission

UNIVERSITY OF BIRMINGHAM CODE OF PRACTICE ON LEAVE OF ABSENCE PROCEDURE

Application and Admission Process

National Survey of Student Engagement The College Student Report

APPLICATION FOR SPD STUDY AWARDS

Emergency Medical Technician Course Application

APPLICATION FORM STUDY TOUR MASTER PROGRAMMES

Attach Photo. Nationality. Race. Religion

Master s Degree Programme in East Asian Studies

Application for admission to an undergraduate course at the National University of Singapore in Academic Year

Degree Regulations and Programmes of Study Undergraduate Degree Programme Regulations 2017/18

ADMISSION OF STUDENTS INFORMATION AND GUIDELINES/PROCEDURE

Address. Zip Code City State Country

GPI Partner Training Manual. Giving a student the opportunity to study in another country is the best investment you can make in their future

P920 Higher Nationals Recognition of Prior Learning

Please complete these two forms, sign them, and return them to us in the enclosed pre paid envelope.

Application for Admission

Undergraduate and Graduate Study Abroad / Exchange Application Form

Freshman Admission Application 2016

Sl. No. Name of the Post Pay Band & Grade Pay No. of Post(s) Category

Joint Study Application Japan - Outgoing

Application for Fellowship Theme Year Sephardic Identities, Medieval and Early Modern. Instructions and Checklist

Entry form Practical or Theory exams

APPLICATION DEADLINE: 5:00 PM, December 25, 2013

EMPLOYMENT APPLICATION Legislative Counsel Bureau and Nevada Legislature 401 S. Carson Street Carson City, NV Equal Opportunity Employer

MONTPELLIER FRENCH COURSE YOUTH APPLICATION FORM 2016

Application Form Master Course Altervilles First Year M1

IN-STATE TUITION PETITION INSTRUCTIONS AND DEADLINES Western State Colorado University

TRANSFER APPLICATION: Sophomore Junior Senior

Research Training Program Stipend (Domestic) [RTPSD] 2017 Rules

HiSET TESTING ACCOMMODATIONS REQUEST FORM Part I Applicant Information

KENT STATE UNIVERSITY

Special Educational Needs and Disability (SEND) Policy

CHANAKYA NATIONAL LAW UNIVERSITY NYAYA NAGAR, MITHAPUR, PATNA

Upward Bound Math & Science Program

Casual and Temporary Teacher Programs

Pharmacy Technician Program

Special Educational Needs and Disability (SEND) Policy. November 2016

UNIVERSITY OF NEW BRUNSWICK

Reviewed December 2015 Next Review December 2017 SEN and Disabilities POLICY SEND

NIMS UNIVERSITY. DIRECTORATE OF DISTANCE EDUCATION (Recognized by Joint Committee of UGC-AICTE-DEC, Govt.of India) APPLICATION FORM.

Verification Program Health Authority Abu Dhabi

University of Arizona

SRI RAMACHANDRA UNIVERSITY (Declared under Section 3 of the UGC Act, 1956)

HONG KONG INSTITUTE OF CERTIFIED PUBLIC ACCOUNTANTS

Scholarship Application For current University, Community College or Transfer Students

APPLICANT S INFORMATION PACK

DEPARTMENT OF EXAMINATIONS, SRI LANKA GENERAL CERTIFICATE OF EDUCATION (ADVANCED LEVEL) EXAMINATION - AUGUST 2016

Frequently Asked Questions

Introduction to the HFLE course

Indian Statistical Institute Indian Institute of Technology Kharagpur Indian Institute of Management Calcutta

Part - I Particulars of Applicant: 1. Name (Full Name in Block Letters) 2. Date of Birth 3. Place of Birth 4. Address for communication

TK1019 NZ DIPLOMA IN ENGINEERING (CIVIL) Programme Information

Bellevue University Admission Application

RECRUITMENT REPRESENTATIVE APPLICATION FORM

Tamwood Language Centre Policies Revision 12 November 2015

Special Educational Needs & Disabilities (SEND) Policy

Loudoun Scholarship Application

Guidelines for Completion of an Application for Temporary Licence under Section 24 of the Architects Act R.S.O. 1990

RASHTRASANT TUKADOJI MAHARAJ NAGPUR UNIVERSITY APPLICATION FORM

IMPORTANT: PLEASE READ THE FOLLOWING DIRECTIONS CAREFULLY PRIOR TO PREPARING YOUR APPLICATION PACKAGE.

APPLICANT INFORMATION. Area Code: Phone: Area Code: Phone:

Pharmaceutical Medicine

University of Oxford: Equality Report 2013/14. Section B: Staff equality data

UW-Waukesha Pre-College Program. College Bound Take Charge of Your Future!

CIN-SCHOLARSHIP APPLICATION

Table of Contents. Internship Requirements 3 4. Internship Checklist 5. Description of Proposed Internship Request Form 6. Student Agreement Form 7

WASHINGTON STATE. held other states certificates) 4020B Character and Fitness Supplement (4 pages)

STUDENT HANDBOOK ACCA

Navitas UK Holdings Ltd Embedded College Review for Educational Oversight by the Quality Assurance Agency for Higher Education

Arizona GEAR UP hiring for Summer Leadership Academy 2017

KSKV Kachchh University Invites Applications for PhD Program

Bihar State Milk Co-operative Federation Ltd. - COMFED: P&A: Advertisement No. - 2/2014 Managing Director

ESIC Advt. No. 06/2017, dated WALK IN INTERVIEW ON

Application Form for a Provisional License

COLLEGE OF INTEGRATED CHINESE MEDICINE ADMISSIONS POLICY

Transcription:

Application Form 2014-15 Undergraduate Studies Dear Applicant, At the London School of Business and Management (LSBM) we guarantee immediate application processing with a quick turnaround. Once you complete and submit this Application Form, you should expect to hear back from us within no more than 10 working days. In order to expedite the process and to help you get your questions answered as quickly as possible, we request that you pay close attention to each section of this Application Form. Please answer every question with due care. Also, make sure to use block capitals when writing in your answers. Detailed guidance is provided on pp. 7-8. You are encouraged to read these notes carefully before completing each section. Our Application Forms are available by request directly from the LSBM Admissions Office. Applications can also be made online on our website: www.lsbm.org.uk. You are required to comply with the Application Guidance Notes, which accompany this Application Form. Moreover, before submitting your application please make sure that you have looked at the Application Checklist and enclosed/attached copies of all the required documents. Detailed information about the Admissions Process at the London School of Business and Management can be found in the LSBM Admissions Policy, which is available at: www.lsbm.org.uk/courses. The LSBM Terms and Conditions for Student Application, Enrolment and Tuition Fees can be found here: www.lsbm.org.uk/apply-now. Please ensure to complete the anonymous Equal Opportunities Monitoring Form attached on page 9 of this Application Form. With best wishes, LSBM Team PLEASE COMPLETE IN BLOCK CAPITALS 1) Student Details Mr / Mrs / Ms / Miss (Circle as applicable) First name(s) (As shown on Photo ID) Last name (As shown on Photo ID) 2) Contact Information Current place of residence House name/number Street Gender Male Female Other City Postcode Date of birth Town/City of birth Country of birth Nationality / / DD MM YYYY County Country Permanent address (If different from above) Photo ID type (E.g. Passport) Photo ID number NI number Expiry date / / D DD MM YYYY Have you lived in the UK for three or more continuous years? Yes No Phone + Country code Do you currently hold or require a UK visa? Yes UK visa type, number and expiry date (If applicable) No Mobile + Email address Country code How did you hear about LSBM? Local Agent* Student Referral* Web Search Hotcourses British Council/Education UK School/College Visit Friend / Family Other* Secondary email address *Please specify 1

3) Courses From the list below please select the course you are applying for. BTEC HND Business (2 years) As awarded by Pearson BA (Hons) Business Studies (3 years) BA (Hons) Business and Management Top-up (1 year) BA (Hons) Int l Business Communications Top-up (1 year) BA (Hons) Int l Tourism Management Top-up (1 year) LLB (Hons) Law (3 years) BTEC HND Computing & Systems Development (2 years) As awarded by Pearson BSc (Hons) Business Computing (Systems) (3 years) BSc (Hons) Business Computing (Web Design) (3 years) BSc (Hons) Business Computing Systems Top-up (1 year) BA (Hons) Events Management Top-up (1 year) LLB (Hons) Law (2-year intensive) 4) Start Month & Year From the list below please select your preferred course start date. Refer to the LSBM website or contact the Admissions Office for specific course commencement dates. September January/February Year _ 5) Academic Qualifications Have you completed a first degree in the UK or any other country? Yes No In the space below please list your educational qualifications, starting from the most recent ones. An example has been provided for you. Attach copies of certificates and transcripts with this application. Certified English language translation should be provided for all certificates and transcripts in languages other than English. Do not send original certificates. Institution Name and Address LSBM Dilke House, 1 Malet Street, London WC1E 7JN, United Kingdom Qualification Type Course Length Awarding Body (if known) Relevant Subject(s) Taken Grade Achieved BTEC Higher National 2 years Pearson Business Environment, Merit E Diploma in Business X A M Marketing, P Managing L Pass E NQF Level 5 Financial Resources and Pass Decisions, Business Strategy Date Started and Date Awarded September 2010 September 2013 2

6) English Language Qualification Students whose first language is not English or who do not hold a degree from an English-speaking country, as approved by the UK Home Office, are required to obtain an English language qualification. For further details, please refer to section 7 of the Application Guidance Notes (page 7). In the space below please give details of your most recent English language qualification. Attach a copy of the test certificate with this form or request the test provider to send your results directly to the London School of Business and Management (LSBM) office. Reason if not applicable: Test Provider (Please tick as applicable) Cambridge ESOL Oxford Online Placement Test Trinity Other: Applicant has a nationality from a majority English speaking country (including UK) Applicant holds a degree from majority English speaking country Applicant switching from Tier 4 (Child) to Tier 4 (General) City & Guilds Educational Testing Service (ETS) Pearson University English Access Course (UEAC) Date Test Taken / / DD MM YYYY Tick here if you would like to apply for our University English Access Course (UEAC) Full details are available at: www.lsbm.org.uk/ueac 7) Professional Experience Speaking Score Listening Score Reading Score Writing Score OVERALL Results In the space below please list your employment experience to date, starting from the most recent position held. Leave this section blank if you have no previous professional experience. Start Date and End Date Employer s Name and Address Position Held Full Time or Part Time Duties Reason for Leaving 8) References Please provide details of your referees. The first referee must be academic and the second should be professional. If you have no previous work experience you may provide two academic references instead. The referees may email/post a reference directly to LSBM. First Referee Mr/Mrs/Ms/Miss (Circle as applicable) First name(s) Last name Second Referee Mr/Mrs/Ms/Miss (Circle as applicable) First name(s) Last name Address Address City Postcode City Postcode Position/Occupation Relationship to applicant Phone Email address Position/Occupation Relationship to applicant Phone Email address 3

9) Additional Personal Information 9.1) PHYSICAL OR OTHER DISABILITY, OR MEDICAL CONDITION Do you consider yourself to have any physical or mental health difficulty, or a specific learning difficulty, which might affect your studies and for which you may need support from LSBM? Yes* No (Please go to section 9.2) Please refer to the list below for examples. Asperger's syndrome / other autistic spectrum disorder Blind / visual impairment uncorrected by glasses Deaf / serious hearing impairment A long standing illness or medical condition, such as cancer, HIV, diabetes, chronic heart disease, epilepsy A mental health condition, such as depression, schizophrenia or anxiety disorder Specific learning difficulty such as dyslexia, dyspraxia or AD(H)D Physical impairment or mobility issues, such as difficulty using your arms or using a wheelchair or crutches Disability, impairment or medical condition that is not listed above Two or more impairments and/or disabling medical conditions *If you have answered Yes, a designated staff member from the Disability Office will contact you in confidence to establish your needs and confirm LSBM can and will make special arrangements to accommodate you. Will you be in receipt of Disabled Students Allowance (DSA)? Yes 9.2) ACCOMMODATION ARRANGEMENTS No LSBM can assist you in securing accommodation for the period of your studies through our partners. Do you require accommodation assistance? Yes No* *If you do not require assistance, what are your accommodation arrangements? Living with family Student accommodation Rented accommodation Other* *Please specify: 9.3) CRIMINAL CONVICTIONS Have you ever been convicted of a criminal offence either in the UK or in another country?* Yes No If you answered yes, please specify (Attach a separate sheet if necessary): * Please refer to section 9.3 in the Application Guidance Notes on page 8. 10) Funding Source Who will pay your fees? Self-funding Grant/scholarship Student Loans Company (SLC)** Other* Employer Student Finance England (SFE) *Please specify 4 Student Finance Services (SFS) Europe SLC Customer Reference Number (if known): ** Please note that government funding support for the courses validated by the University of Northampton is subject to specific course designation by the Department of Business, Innovation & Skills (BIS). Tick here if you d like more information about funding options or require assistance with your SLC application. 11) Personal Statement The Personal Statement is your chance to tell us why you deserve the opportunity to study at LSBM. It therefore is an essential part of your application and an important consideration for our academic department in determining whether to offer you a place on your preferred course. Your Personal Statement should be between 300-550 words. This is an individual piece of writing, so please ensure to prepare it without any unacknowledged external help. Plagiarism is the unacknowledged inclusion of material derived from the work of another person (such as from the internet or from another applicant), whether this is intentional or unintentional. The documents that candidates are required to provide to support their application for study, including the Personal Statement, form the basis of an assessment of their academic abilities and suitability for the course. It is vital that such documents are entirely your own work and are therefore free from plagiarism.

You are encouraged to be as creative as you like. However, you may wish to consider some of the following factors: - Who you are. What is your academic and professional background? - Why do you want to study at LSBM? - Why do you want to study your chosen course? - What are your career aspirations? - How will studying at LSBM help you to achieve your goals? Please write your Personal Statement in the space provided below. If required, attach an additional sheet of paper with your name clearly indicated at the top of the page. Your Personal Statement: 5

12) Application Checklist Before an application can be processed you are required to supply copies of all academic and professional records. Originals, along with two passport-sized photographs, must be presented upon enrolment. Documents can either be submitted via email, fax or posted to the address listed in section 14 of this form. Please ensure that you have: Completed ALL sections of this application form, including the anonymous Equal Opportunities Monitoring Form available on page 9. Enclosed/attached copies of exam results, diplomas, certificates, transcripts (originals will be required on enrolment) Enclosed/attached a copy of your passport information/photo page (other forms of photo ID can be accepted for European students only) Enclosed/attached proof of your English language abilities (IELTS/TOEFL/other), if applicable 13) Declaration I certify that all of the information I have submitted as part of this application is truthful, complete and accurate to the best of my knowledge. I understand that LSBM can admit or revoke an acceptance on a course based on its judgement of suitability. I acknowledge that LSBM reserves the right to revoke an offer if the information provided in or with this form is found to be fraudulent. I authorise LSBM to contact my referees for the purpose of evaluating my application. I confirm that I have read and understood the LSBM Admissions Policy, available at: www.lsbm.org.uk/courses. Signature Date / / DD MM YYYY 14) LSBM Contact Details Please send your completed application form, along with attachments, to the postal address or the email address below. London School of Business and Management (LSBM) Admissions Office Dilke House 1 Malet Street London WC1E 7JN United Kingdom Tel: +44 (0)20 7078 8840 Fax: +44 (0)20 7636 7291 For all application-related queries: admissions@lsbm.org.uk For more information about the application process, please visit our website www.lsbm.org.uk or contact a Student Recruitment Executive. DATA PROTECTION ACT 1988 The information collected on this form will be used for administering an application to the London School of Business and Management. The records created with regard to this data are subject to regulation by the Data Protection Act 1998. The information contained within our records may be used for reporting, both internally within the School and to the relevant external bodies. EMPLOYMENT POLICY The College cannot guarantee employment in the UK. Whilst efforts are made to support students with CV facilitation and internship programmes, the School and its partners should not guarantee placements. If assurances are presented to students by third parties, please report to the Admissions Office immediately. MARKETING POLICY The London School of Business and Management may contact you with information about further academic and/or professional training, or other services and products of interest. Please tick this box if you do not wish to receive any such information (Once subscribed, you can opt out at any time.) The London School of Business and Management (LSBM) is an unlisted limited company, registered at Companies House for England and Wales under Company Number 04511191. 6

Application Guidance Notes 1) Student details 1.1 Your name and photo ID Your name will be the basis for creating your applicant record, so please ensure it is indicated in full and accurately. You should state your name exactly as it is printed in your passport or other official document, which will be of primary importance if you need to apply for a student visa. If you contact us after submitting your application, please provide your name exactly as indicated in your application, as it will enable us to match all enquiries to the correct record. 1.2 Nationality and citizenship Please include all countries of which you currently have nationality. If you are not a national of an EEA country (including UK, Channel Islands and Isle of Man) or Switzerland, please provide details of the passport that you intend to use to enter the UK. For students who require a UK visa, please note that this also includes those with an Indefinite Leave to Remain. 2) Contact information You must ensure that we always have your current and accurate email and postal addresses. If your contact details change, you must notify us immediately, as we will need to contact you throughout the admissions process. If you are applying for a loan through the Student Loans Company, note that if you are a resident of the EEA and have not been a resident of the UK for 3 continuous years you will be eligible for the Tuition Fees loan only. Your proof of residency will be required at enrolment. 3) Your course preference You are required to select your choice of course from a list of available courses. If the course you wish to apply for is not listed as an available option, it may be featured on the Postgraduate Studies Application Form. 4) Start month & year You may only select one start month and year for your course. If you wish to apply for an alternative start month, you should contact the Admissions Office in the first instance regarding whether this could be supported. 5) About your academic qualifications Please ensure that you include details of all qualifications and periods of study undertaken at secondary and university level; do not provide details or documentation of your primary education. 6) Your language skills and admissions tests Where required, evidence of English proficiency needs to be in the form of a certificate of an English language test taken within two years of the course commencement date. Enter your detailed scores on this page and enclose a copy of the certificate together with the application. If you do not have test results at the time of applying, you should contact Admissions as soon as they are available, and they will be matched with your application. English language test results are not required if you are from a majority English language speaking country and if you hold a passport of any of the following countries: Antigua and Barbuda, Australia, the Bahamas, Barbados, Belize, Canada, Dominica, Grenada, Guyana, Jamaica, New Zealand, St Kitts and Nevis, St Lucia, St Vincent and the Grenadines, Trinidad and Tobago, United States of America. Alternatively, English language test results are not an essential component of the application if you have completed an academic qualification at least equivalent to a UK Bachelor s degree which was taught in one of the following majority English-speaking countries: Antigua and Barbuda, Australia, the Bahamas, Barbados, Belize, Dominica, Grenada, Guyana, Ireland, Jamaica, New Zealand, St Kitts and Nevis, St Lucia, St Vincent and the Grenadines, Trinidad and Tobago, the UK, United States of America. For students who wish to improve their English language skills before the start of their chosen course we offer the University English Access Course (UEAC). Detailed information is available at www.lsbm.org.uk/ueac. 7) Your professional experience Please ensure that you include details of all work experience undertaken prior to applying to LSBM. Leave this section blank if you have no previous professional experience. 8) About your references Please provide details of two persons whom we can contact regarding your suitability to enrol on the course of your choice. The first referee must be academic and the second should be professional. If you have no previous work experience you may provide two academic references instead. 9) Additional personal information 9.1 Physical or other disability, or medical condition 7

All admissions decisions are taken based on your academic performance and potential in relation to your chosen course of study. The London School of Business and Management is committed to making reasonable adjustments to enable students with disabilities or longterm health conditions - including Specific Learning Difficulties such as dyslexia, dyspraxia, Asperger Syndrome and mental health difficulties - to apply for study and participate fully in student life. If you wish to discuss this section of the application form, or anything to do with the LSBM provision for such needs, please contact our Disability Office: Tel: +44 (0)20 7078 8840 Fax: +44 (0)20 7636 7291 Email: disability@lsbm.org.uk 9.2 Your accommodation needs In this section please give an indication of your plans regarding whether you intend to apply to LSBM for accommodation assistance. 9.3 Criminal convictions The London School of Business and Management does not want to deter individuals with criminal convictions from taking advantage of the opportunities provided by higher education. However, the College has to take into account the requirements of various partners and to take reasonable steps to provide as safe an environment as possible for its staff, students and visitors. You are therefore required to declare any unspent convictions, excluding motoring offences for which a fine and/or three penalty points were imposed. You are not required to declare spent convictions unless the course to which you are seeking admission falls within the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. All the provided information will be treated in full confidence. 10) About your funding You must complete this section by indicating with the tick box the main source(s) of funding you are most likely to use to fund your tuition fees. If you are in the process of applying for a loan from the Student Loans Company (SLC), or you are considering this option, tick at the end of this section if you would like to receive more information or require assistance with your SLC application. If you are applying for a loan through the Student Loans Company, note that if you are a resident of the EEA and have not been a resident of the UK for 3 continuous years you will be eligible for the Tuition Fees loan only and you can only apply through Student Finance Services Europe. Note that there is no application fee for LSBM Admissions to consider you for a place at the London School of Business and Management. 8 11) Your Personal Statement The Personal Statement is your chance to tell us why you deserve the opportunity to study at LSBM. It therefore is an essential part of your application and an important consideration for our academic department in determining whether to offer you a place on your preferred course. Your personal statement should be between 300-550 words, and should be written on the designated page of the Application Form. Because the Personal Statement is an individual piece of writing, please ensure to prepare it without any unacknowledged external help. Plagiarism is the unacknowledged inclusion of material derived from the work of another person (such as from the internet or from another applicant), whether this is intentional or unintentional. The documents that candidates are required to provide to support their application for study, including the Personal Statement, form the basis of an assessment of their academic abilities and suitability for the course. It is vital that such documents are entirely your own work and are therefore free from plagiarism. 12) Application checklist Before an application can be processed you are required to supply copies of all academic and professional records. Originals, along with two passport-sized photographs, must be presented upon enrolment. Use this checklist to ensure that you have compiled and submitted all the required documents, which can either be sent via email, fax or posted to the address listed in section 14 of the Application Form. You will be contacted individually to confirm your submission. Please note that confirmation of submission is not a confirmation that your application is complete for the purpose of assessment. 13) Your Declaration By signing and dating this Declaration you are confirming that all of the information provided is, to the best of your knowledge, true, accurate, current and complete, and that you will promptly notify LSBM if any information should change in order to keep it true, accurate, current and complete. You are also confirming that the information contained in your application, including all supporting work, is entirely your own original work, except where clearly indicated, and does not contain any plagiarised elements 14) Further advice and contact details Refer to information in this section for questions of an academic nature about specific courses of study, as well as if you have general questions about the application process, funding, or if you have a query or complaint regarding the admissions process.

EQUAL OPPORTUNITIES MONITORING FORM The London School of Business and Management (LSBM) is committed to a policy of equal opportunities. To enable the College to monitor the effectiveness of this policy, applicants are asked to complete this Monitoring Form. This information is used solely for the purpose of monitoring application and admission rates and forms no part of the selection procedure. Please return the form together with your application. The Monitoring Form is anonymous. It will be separated from the Application Form and will not be forwarded to any member of staff involved in evaluating your application. Age Please tick the box which applies to your age group. 18 25 years 26 35 years 36 45 years 46 55 years 56 65 years 66 75 years 76 years and over Prefer not to say Ethnicity Please tick the box which best applies to your ethnicity. Asian or British Asian - Bangladeshi Asian or British Asian - Indian White - British Asian or British Asian - Pakistani Asian - Other White - Other Black or Black British - African Black or Black British - Caribbean Other including mixed Black or Black British - Other Chinese Prefer not to say Gender Please tick the category which applies. Female Male Other (please describe: ) Prefer not to say Impairments Please tick all that apply. A specific learning difference (e.g. dyslexia) Blind/partially sighted/visually impaired Deaf/hearing impaired Wheelchair user/mobility/dexterity impairments Mental health issues Asperger s Syndrome Medical condition (e.g. diabetes/epilepsy/asthma/me) Other impairments: No impairments Prefer not to say Religion Please tick the box which applies. No religion Sikh Muslim Christian Buddhist Other: Jewish Hindu Prefer not to say Sexual orientation Please tick the one which applies. Bi-sexual Heterosexual Gay Lesbian Prefer not to say 9