UCL CENTRE FOR LANGUAGES & INTERNATIONAL EDUCATION Part-time English Courses 2015-2016 Enrolment Form Applications for these courses can be submitted during the advertised enrolment periods below to the EAP Office, Room 121, UCL Centre for Languages & International Education, 26 Bedford Way, London WC1H 0AP Enrolment for Term 1 Enrolment for Term 2 Enrolment for Term 3 30 September – 7 October 2015 7-10 December 2015 16:00-17:00 21-23 March 2016 16:00-17:00 13-20 January 2016 (weekdays) 15:30-17:30 25-29 April 2016 15:30-17:30 (weekdays) 15:30-17:30 Personal details Title (Mr /Ms /Mrs /Dr ) First name(s) Surname Date of birth Sex (male / female) Current university / place of study UCL Other (please state where) UCL Student Number Undergraduate Nationality Department name Postgraduate Title of degree course Which year did you begin your studies? English language qualification (e.g. IELTS / TOEFL / CAE / CPE) Email address Telephone contact(s) (Home / Mobile / Work) Course name Price per course (Please ) UCL NonUCL Course name Price per course (Please ) UCL NonUCL One-term courses for UCL and non-UCL students Academic Writing for students on taught courses (UG & PG) Academic Writing £250 Academic Speaking and Pronunciation Courses £350 Academic Speaking Skills (Term 1, Term 2) £220 £270 £170 £350 £250 £220 £420 £300 £220 £270 £300 £400 Option A £480 £600 Academic Speaking Skills (Term 3) Pronunciation and Public Speaking Pronunciation (Term 1, Term 2) Option B £350 £400 Pronunciation (Term 3; 6 weeks) Academic Reading / Listening Skills Thesis Writing (for current MPhil/ PhD students only) Advanced Grammar Advanced Grammar (Term 1, Term 2) £170 £220 Advanced Grammar (Term 3; 6 weeks) £120 £170 Two-term course for UCL students only In-sessional EAP (Terms 1 & 2; 17 weeks) £450 Academic Reading & Listening Academic Reading only £170 £220 Academic Listening only £170 £220 Are you required by your department or UCL Registry to take this course? YES NO For Office Use Amount paid: £ ........... Term: ............ Payment method: ……….. Date: .............. 1 Please give details of any previous courses you have taken with us: How did you hear of our courses? Please tick: CLIE website UCL publicity Dept. tutor or UCL Registry Facebook / Twitter CLIE Reception Other (please specify): ………………………………. Enrolment notes: 1. To enrol on most courses, simply complete pages 1 and 2 of this Enrolment Form and go to the EAP Office, Room 121. Our EAP administrator will ask for your signed form and full course payment in order to complete your course enrolment. 2. When choosing from our courses, if you have any questions concerning academic content, please speak to one of the CLIE teachers available at Reception during advertised enrolment period hours. 3. To enrol on In-sessional EAP or Academic Speaking Skills only: before going to Room 121, please attend a short interview with one of the CLIE teachers at Reception during enrolment hours. After the interview, the teacher will confirm your suitability/English level for the course and complete the boxes below as appropriate. No prior appointment is necessary for these interviews. TO BE COMPLETED BY CLIE TEACHER AT RECEPTION DURING INTERVIEW (or by Daphne Thomas, Part-time Courses Co-ordinator) In-sessional EAP C /UC Academic Speaking Skills Initials Date 4. UCL research students (MPhil/ PhD) who wish to apply for Doctoral Skills Development Programme funding to take the Pronunciation and Public Speaking course or Thesis Writing (Option A, Option B) should complete all 4 pages of this application form. As part of this funding application, you will need to request approval from your UCL tutor, using pages 3 and 4. Once this approval is received from your tutor, take all 4 pages to the Doctoral Skills Development Programme office and have page 2 below signed. Finally, bring pages 1 and 2 to the EAP Office in Room 121 to reserve your place on a course. Please read and sign to confirm your understanding: Fees are not refundable once a course has commenced, and no partial refund can be given for any classes not attended. The CLIE cannot accept responsibility for unforeseen changes in a participant’s circumstances that may prevent attendance. The CLIE reserves the right to cancel a class where necessary. In this case only, course fees will be refunded in full. Signed: ...................................................................... Date: ........................................ For Doctoral Skills Development Programme Use Courses Applied For: (Please state term) Thesis Writing Option A Thesis Writing Option B Pronunciation and Public Speaking Signature: ……………………… Date: ………………….. Please note that Doctoral Skills Development Programme funding is not guaranteed and there may be occasions when it is not possible to make an award. 2