Language Learning Unit
Modern Languages 2015/16
If you wish to enrol for a language module as elective counting towards your degree please complete the selfassessment below and then submit it to an LLU administrator.
Please note: Students are not allowed to take more than one language stage 1 module within the same
academic year. Year 3 students are not permitted to enrol onto language stage 1 or 2 modules as part of
their Final Year study credits.
A: Language Module – Student Self-assessment Form – Student to complete
Student Name
Student Number
Keele E-mail address only (if known)
Nationality AND first language
Main degree subject(s)
Year of Student (FY, 1st Yr , 2nd Yr, 3rd Yr, PGT, PGR,
Study Abroad)
Which language would you like to study ?
In which semester do you wish to take a language
module (autumn semester, spring semester, or both)
Please give details of any official qualifications in the
chosen language (e.g. A-level, GCSE, IB, CEF)
including year of award and grade received
Have you attended any module(s) in the chosen
language at Keele previously?
If yes please provide your module mark(s)
Do you have any other experience of the language
not captured above (e.g. ‘absolute beginner’; ‘one
year at school 3hrs per week 5 years ago’, ‘Three
months spent in target country in 2011’, ‘Lived and
attended primary school in target country’)
Have you learnt any other foreign language(s) apart
from the one chosen above?
If you are not a native speaker of English have you
previously attended or are currently enrolled on any
English Language modules at Keele (e.g. EAP 2,
ABEC etc)
Declaration
I hereby declare that the above details regarding previous language qualifications and language learning
experiences are correct and complete. Failure to disclose qualifications or substantial language learning
experiences are considered to constitute Academic Misconduct.
Name and date
.....................................................................................................................
FOR OFFICE USE ONLY
Approved/suggested level: …………………………………………..
Signed by ………………………………………….
Date ………………………………………………..
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