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Foundation Programme 2016 Application Form

(international applicants only)

I wish to apply for the foundation programme in: Engineering and Physical Sciences Science Social Sciences and Business Arts and Humanities Leading to the honours degree course in: Proposed date of admission (month and year of entry): Title: (delete as applicable) Mr/Mrs/Miss/Ms/Other Surname (as per passport): Forename(s) (as per passport): Date of birth (day/month/year): Age at start of foundation course (years/months) Gender: (delete as applicable) male/female Nationality: Country of birth: Country of permanent residence: Correspondence address (please note this is the address to which the University will send all correspondence): Home address (if different to above): Email address: (Important: give an email address you will be able to check frequently both in your home country and the UK. If your application is successful, you may need to receive important information quickly.) Telephone number: Fax number:

Education from age 11 (previous academic institutions attended, for example schools/colleges):

Name of institution From (month/year) To (month/year)

Qualifications completed (examinations for which results are known, including those not completed successfully):

Result/grade mark Month/year Subject Level/qualification

Qualifications pending (examinations or awards to be completed or results pending):

Level/qualification Month/year Subject

English Language qualifications (please enclose a copy of your English language qualifications):

Type of test Score

IELTS TOEFL O-level/GCSE/SPM Other (please specify)

Date obtained

You should send a reference from an academic referee (ie someone who has taught you). Please complete all details below: Full name: Position: Address: Telephone number: Email address:

How will your course be financed? (if sponsored please give details) Do you have a criminal conviction? Yes/No If you have special needs owing to a disability (including dyslexia) or a specific learning difficulty, please give details: I certify that, to the best of my knowledge and belief, the foregoing statements are true. Signed: Date (dd/mm/yyyy)

Please check that your application is complete and that you have enclosed all the relevant documents:

Transcript of previous studies English Language qualification certificate Reference How did you find out about this course? General web search Visited the University website directly British Council paper based materials External organisation (provide details) School careers event British Council website Other advertising (provide details) Other (provide details) You may submit this form and supporting documents by email to [email protected]

. Alternatively you can type in your details and print this form then submit by post to the address below: Foundation Programme Applications Admissions Office The University of Nottingham University Park Nottingham NG7 2RD United Kingdom Thank you for your interest in our foundation programmes and for completing this form.

For Office use only

Date received: