Academic Year 2015/16
Module Choice Form
Semesters 1 & 2
All students should complete this form (overleaf), prior to attending a
programme of study at the University of Bolton.
PLEASE READ THESE NOTES CAREFULLY BEFORE CHOOSING MODULES
1) Go to counselling session with Academic Counsellor as indicated in your instructions.
2) Using the Timetable for 2015/16 choose your modules. When completing the Module
Choice Form please make sure that your Student Number is transferred correctly and
that you give Module Codes as well as the Module Title. Please check that you have
not chosen modules that clash i.e. run on the same day and time. This is shown in the
occurrence (Occ) column overleaf.
3) Please ensure that you record your Pathway(s) and your mode of study in the space
provided.
4) You must obtain Academic Counsellors’ signatures for each Module and Pathway to
approve your academic programme.
5) Please note that Module Choice Forms are registering a choice only. Please note that
we are unable to guarantee acceptance on modules. Whilst we will do our best to
accommodate your preferences, you should be aware that your form indicates a choice,
not acceptance on a module. Confirmation of your programme will be given to you as a
personalised timetable.
6) Once your timetable has been issued you have two weeks at the beginning of each
semester to make changes.
7) If you are intending to complete your studies this academic year, please ensure that you
will have gained all relevant credits/modules for your award. It is your responsibility to
discuss with your Academic Counsellor any problems relating to completion of
credits/modules in the normal course length.
8) You will be contacted should your choice of modules produce a clash or the module
becomes full.
You are urged to resolve any problems with your programme
immediately.
If you are full-time you may normally study modules worth a maximum of 60 credits per
semester.
If you are part-time you may normally study modules worth a maximum of 40 credits per
semester or 100 credits per academic year.
When completed - Please return this form to the Student Centre
Academic Year 2015/16
Module Choice Form - Semesters 1 & 2
Personal Details:
Pathways
Surname:
Single:
Forenames:
Major:
Student No:
Joint:
Full-time 
Part-time 
For Office use only
Associate 
Received by:
Module No
Minor:
Office:
Module Title
Minor:
Minor:
Minor:
Date:
Occ
Credits
Pathway
Leader’s
Initials
Semester 1 – Modules starting in September/October
1:
2:
3:
4:
5:
Semester 2 – Modules starting in January/February
1:
2:
3:
4:
5:
Total credits this year
Pathway Leader’s Signature (All Students)
Pathway I:
Pathway II:
Name (Print)
Signed
Extension:
Name (Print)
Signed
Extension:
Note to Pathway Leaders – Your signature denotes approval of the academic programme of modules
chosen and its appropriateness for the student’s pathway(s) and mode of study.
STUDENT DECLARATION
I confirm that the modules listed above are those that I am already undertaking, or are my firm choice for the coming session.
I understand that it is my responsibility to ensure that the credits I intend to accumulate this year will enable me to complete my
programme of study within the timescale I have planned.
I understand that, if I am a part-time student, I must pay the module fee for any of the modules above which I subsequently
decide I do not wish to follow, if I do not inform the Faculty Office in writing before the closing date for module changes.
I understand that I will be included in the list of students to be considered by the examination board unless I have withdrawn in
the prescribed way.
Student signature:
Date:
For guidance on how to complete this form – Please see over