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Enrolment/Payment
Once you have been
accepted you will be sent details fo how and wghere to join your course
and of the Orientation programme. Full payment will be due before you
start the course. You will be asked to pay a non-refundable deposit
of £250 within one month of receiving your acceptance letter to
secure your place. The balance of the fee will be due six weeks before
the start of the course. Payment can be made by cash, cheque, credit
card or bank transfer. Visa letters for immigration purposes cannot
be issued until your fees have been paid in full.
Please complete
in BLOCK capitals
Course Details
Please include a
first, second and third choice course title and your preferred dates
below:
1st Choice:___________________________________________________
Date:________________________________________________________
2nd Choice:___________________________________________________
Date:________________________________________________________
3rd Choice:___________________________________________________
Date:________________________________________________________
Applicant Details
Title:___________________
First Name: __________________________________________________
Last Name: __________________________________________________
Nationality:______________
Date of Birth:____________
Home (Permanent)
Address: _________________________________
_________________________________________________________
Contact Address:__________________________________________
_________________________________________________________
Home Telephone Number:
(day): _______________________
(evening): ___________________
Fax: ___________________________
email: ___________________
Contact Telephone
Number:
(day): _______________________
(evening): ___________________
Fax: ___________________________
email: ___________________
Would you like us
to assist with your accomodation requirements? (Yes/No)
_______________
Nominated Personal
Contact
Please provide the
details of someone we may contact on your behalf in case of emergency:
Name: _____________________________________________________________
Relationship to
you:___________________________________________________
Daytime telephone:___________________________________________________
Evening telephone:___________________________________________________
Address:___________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Marketing Information
How did you hear
about this course?
Newspaper/magazine:
Brochure:
Internet:
Friends:
Would you like to
be added to our mailing list? This information will not be forwarded
to third parties. (Yes/No) ___________
Educational Details
Tick a box to indicate
what your class will be at the time of the Study Abroad programme:
Sophomore:
Junior:
Senior :
Other:
Major:_____________________________________________________________
Minor:_____________________________________________________________
GPA 4.0 scale:______________________________________________________
Home college or
university:____________________________________________
Department/faculty:__________________________________________________
Telephone:_________________________________________________________
Facsimile:__________________________________________________________
University/college
address: ____________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Academic Reference
A letter of support
is required from your Programme Leader and should be enclosed with.
Please give their name and address and ask them to write a letter supporting
your application.
Name:_________________________________
Position:_______________________________
Telephone:_____________________________
Facsimile:_____________________________
Email:_________________________________
Address:___________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Personal Statement
Please use this
space to describe what it is that you would like to achieve on your
programme and in your time in London. You may continue on a separate
sheet if necessary.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Terms & Conditions
The terms and conditions
governing succesful candidature to the Study Abroad programme are given
here as information and guidance:
1: All course fees
must be paid in full at least six weeks before the course starts.
2: Cancellation
and withdrawals for any reason whatsoever from a course must be received
in writing. Cancellations and withdrawals are permitted up to six weeks
before the start of the course. Students whop do not attend due to illness
or professional commitments do not have the right to refunds or transfers.
No refunds will be made to students who cancel or withdraw less than
six weeks before the start of the course. The deposit of £250
is not refundable in any circumstance.
3: Students are
required to have adequate health, accident, disability and hospitilisation
insurance to cover themselves during their time at the London Institute.
Students recognise and expect that no part of the fee goes toward payment
of such insurance and that the London Insitute will not provide any
personal or financial assistance.
4: Students understand
that should they incur legal problems while in the UK, they will attend
to the matter personally with their own funds. They accept that the
London Institute will not provide any personal or financial assistance.
5: Dates, schedules
and course details, given in good faith, are based on information available
at the time of writing, and are subject to change and revision.
6: Students understand
that it is their responsibility to discuss their proposed programme
of study with the appropriate official of the college or university
they expect to attend upon their return to ensure compatibility of course
syllabus.
7: It is the student's
responsibility to discuss the course work with their department advisor
and to secure written approval.
8: This is a programme
of Developments at London Institute Ltd (DALI), 65 Davies Street, London,
W1K 5DA, Reg. No: 510 395 660. The information published through this
website describes the Study Abroad Programmes currently being run by
DALI Ltd at the colleges maintained by the London Institute Higher Education
Corporation.
Declaration
Please check the
boxes to indicate that you have made the appropriate enclosures and
sign the following declaration: I have read, understood and agree
to the terms and conditions above and have made all the enclosures indicated.
The completed form:
My transcript:
An academic reference:
Signature:________________________________Date:______________
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