Admission form for courses FacebookTwitterPinterestWhatsApp Please Read carefully Course code First name Middle name Family name Title CaptDrMrMsMrs Nationality Date of birth (day/month/year) Gender MaleFemale Home address City County/State Post/zip code E-mail (essential for communication) E-mail (Enter again for confirmation) Mobile No.(including area code) Mobile No.(including area code)Enter again for confirmation Send correspondence to this addressSend study materials to this address --------------------------------------------------------------- Professional training Please list below details on any Accountancy qualifications you have achieved, e.g. ACCA, CIMA, ICA etc. and indicate whether you have full membership. Date of Entry month/year Date of Graduation month/year Duration of Study no of years FT/PT/DL study —Please choose an option—Full timePart timeDistance learning University/Institution and country Qualification obtained Bachelor, Master ACCA, CIMA etc (please specify title of course) ----------------------------------------------------------------------- Academic credentials/education Please list below, starting with the most recent, all post-secondary institutions attended and qualifications achieved. Please provide information about the results you achieved (average grade, classification, ranking in class etc). Also indicate whether you studied part-time (PT), full-time (FT) or distance learning (DL) and the qualification awarded (Bachelor, Masters, Postgraduate Diploma, etc). Please indicate undergraduate and graduate qualifications only. IMPORTANT: certified copies of certificates, degrees, professional membership certificates (ACCA, ICA, CIMA etc) will need to be provided at your Induction or first workshop. Date of Entry month/year Date of Graduation month/year Duration of Study no of years FT/PT/DL study Full timePart timeDistance learning University/Institution and country Qualification obtained Bachelor, Master ACCA, CIMA etc (please specify title of course) ---------------------------------------------------------------------------- Please indicate below your major field of study (tick one box only): Finance/AccountingScience/MathematicsSciencesBusiness AdministrationComputer Science/ITArtsEconomicsMedicineLanguagesEngineeringLaw SocialBankingTrusts and EstatesOther ---------------------------------------------------------------------------- External testing GMAT and/or TOEFL/IELTS may be required. You will be advised if you are required to take either test. Is English your first language? YesNo If not, what is your first language? If English is not your first language and you have not studied a previous degree at an English speaking institution or worked in an English speaking environment you may be required to take an English language test to prove your competence. We do not accept scores more than two years old. If English is not your first language, please outline your experience of using English. Please indicate whether you plan to take further English language training and let us know what type of training you intend to undertake, where and when. ---------------------------------------------------------------------------- Full-time employment history Total number of years of full-time work experience at start of programme (Years) Please complete this page starting with your current/latest employer. Additional information may be provided on a separate sheet. Name of employer Country Position Brief description of responsibilities Details of your current responsibilities Area of responsibility (please select one in each of the following sections) Job function ConsultingStrategy/Business DevelopmentFinanceSales/MarketingOperations/ProductionsGeneral ManagementInformation TechnologyOther Industry sector FinanceConsultingInformation TechnologyManufacturingTelecommunicationsPublic ServicesPetroleum/Energy/UtilitiesOperations/LogisticsConstructionPharmaceuticals/ChemicalsSports/Events ---------------------------------------------------------------------------- Additional support needs Do you have any physical disability, specific learning difficulty or medical condition, which could affect your studies? (This question is for information only and will not in any way affect your application or status on the programme) YesNo Declaration I apply for admission to the Cambridge Kipp. I understand that the decision to offer me a place rests with the course and ultimately with Cambridge Kipp whose decision is final. If I am offered and accept a place on the programme, undertake to abide by the rules and regulations of Cambridge Kipp. I am aware of the conditions of admission and Cambridge Kipp Business School’s expectations from students on the programme, particularly the need for fluency in the English language and commitment to contributing to the course unique learning environment. Finally I confirm that to the best of my knowledge the information contained in my application is complete and accurate. I understand that information provided earlier as part of my application to study may be processed to form part of my student record. The information held on the student registration form (including amendments) and the digital photographs from the swipe card system are stored as part of my student record on a database. The registration form is also kept as a manual record. The data is held and processed in accordance with the requirements of the Data Protection Act 1998 and within the limits agreed with the Data Protection Officer. This Act requires that any information held is accurate, has been obtained fairly and is not divulged to people without permission or authority. It gives me the right to check the information held and to correct it if necessary. I agree Δ
