Personal Information Section

Select College(s)

Birmingham  Cambridge  London  Manchester  DLD

Student Details

Family Name*
First Names*
Male
Female
Date of Birth*	/ /
Address*
Town*
Country*
Post Code*
Email*
Tel No*
Mobile
Passport Number*
Passport Place of Issue*
Home Language*
Other Languages

Parent/Guardian Details

Family Name*
First Names*
Title*	Mr Mrs Ms Dr Prof
Relationship to student*
Address (if different from student)
Town
Country
Post Code
Email
Tel No
Mobile

Details Of The Person Who Will Be Paying The Tuition Fees

Name of the fee payer*
Occupation*
Address (if different from above)
Town
Country
Post Code
Email
Tel No
Mobile

This Section To Be Completed If There Is A Guardian In The Uk

The college recommends that the parents appoint a guardian resident in the UK for all students who are under the age of 16 years and who are not normally resident in the UK.

Family Name
First Names
Title	Mr Mrs Ms Dr Prof
Address
Town
Country
Post Code
Email
Tel No
Mobile

Education Section

Please Give Details Of The Last School Attended

Name and Address of School / College
Town
Country
Post Code
Name of Headteacher
Dates attended (From/To)	/ / / /

Please Provide Information Below For Any Examinations You Are Likely To Take Before Leaving Your Current School:

Study Options: Please Read The Information Below Carefully And Then Tick The Boxes To Show Your Study Choices:

FULL TIME ENGLISH (EFL,EAP) Start date (please choose) and insert year, e.g. 2011	SUMMER SCHOOL
September 20 start (3 terms)	August 20
January 20 start (2 terms)	July and August 20 (Abbey Cambridge only)
One term

GCSE Programme

Start date (please choose) and insert year, e.g. 2011

September 20 start (3 terms)

A Levels

Start date (please choose) and insert year, e.g. 2011. Subject choices (typically 4 for A level) are to be discussed directly with the College being applied to. If you wish to study A Levels, your current or pending exam results should be equivalent to or higher than GCSE (General Certificate of Secondary Education) in at least 5 subjects and a minimum level of English equivalent to IELTS (5.5 Abbey College Cambridge). For the one year programme you should have completed A Levels before or taken the equivalent qualification. At the start of each academic year of study students following an A Level course without a pass at grade C in GCSE or IGCSE English Language or with an IELTS score below 6.5 must join an English-language training course for the duration of the academic year which will be timetabled alongside A Level lessons. This extra course is chargeable.

2 year programme	18 months programme	1 year programme (not available at Abbey College Cambridge)
September 20 start (3 terms)	January 20 start (5 terms)	September 20 start (3 terms)

International Foundtion Programme

If you wish to study the International Foundation Programme you should have obtained or expect to obtain a qualification accepted by a university in your home country and a minimum level of English equivalent to IELTS 4.5 for 3 terms or IELTS 5.5 for 2 terms. Start date (please choose) and insert year, e.g. 2010

September 20 start (3 terms)

January 20 start (2 terms)

Course type. Please choose.

Business Pathway	Engineering Pathway	Music Pathway	Art Pathway
Abbey College Birmingham	Abbey College Manchester	DLD College only	DLD College only
Abbey College Cambridge
Abbey College London
Abbey College Manchester

College Boarding House

All International Students aged under 18 must live in supervised accommodation or with host families unless living at home with a parent or guardian who is over the age of 21.

Please indicate if accommodation is required?   Yes No

College Boarding House
(Birmingham and Cambridge available from age 15, Manchester from age 17, London accepts under 16s)

Homestay (Available to all students)

Please note the College will advise you on the availability of your option on receipt of your application.

I am aged under 16

Under 16 students must live in private fostering (Birmingham, Manchester), boarding house (Cambridge) or UrbanNest accommodation (London).

Further Information

Medical History

It is important, for your health and welfare during your study at an Abbey DLD College, that these questions are answered comprehensively. Your application will not be prejudiced in any way. If you wish to give details in confidence please contact the Principal of the College.

Please provide details of any physical problems or illness which you feel may affect your progress at college (e.g. deafness, defective vision, heart problems, nervous disposition, allergies etc). Please attach an additional sheet if more space is required to explain the problem.

Do you have any allergies?   Yes No	If Yes Please Specify
Are you currently taking any medication or receiving medical treatment?   Yes No	If Yes Please Specify
Do you have a registered disability or special educational needs?   Yes No	If Yes Please Specify
Do you suffer/have you ever suffered from a major illness?   Yes No	If Yes Please Specify

Ethanic Origin

Please tick the box which best describes your ethnicity. In cases of mixed heritage please give details where asked:

White - British

White - Irish

Any other white background: (Please Specify)  

Caribbean

African

Any other ethnic background: (Please Specify)  

Indian

Pakistani

Bangladeshi

Any other asian background: (Please Specify)  

Chinese

Any other ethnic background: (Please Specify)  

White & Black Caribbean

White & Black African

White & Asian

Any other Mixed background: (Please Specify)  

Signed Declaration

Students Under 16 Years Of Age

All students may leave the premises at break and lunchtime. If your son / daughter is aged under 16 on 1st September of the new academic year, please could you sign below to confirm that your son / daughter may leave the premises and that the college cannot be responsible for the student during this period. At no other time are students allowed out of the building unless permission has been granted by a member of staff.

Full Name
Relationship to Student
Consent*
Date	/ /

Terms & Conditions

I agree to the Terms & Conditions

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