Part-time Application

Please complete this form so that your application may be started

A. Course Details

Name of Course or Modules:

Year/level of course or modules:

Student I.D:

Course number:

B. Personal details

Title, (Mr/Mrs/Ms/Miss/Dr):

Surname:

Forenames:

Home address:

address line 2

Town/City

Postcode:

Tel. no:

Date of Birth. (please enter dd/mm/yyyy numbers only)

day

Month:

Year

Nationality:

Country of permanent residence*:

Have you previously studied at the University

If yes, please state previous course, and year of study:

C. Education

Name of last School/College attended:

Address of last School/College attended:

Academic/Professional Qualifications

Awarding Body

Examination dates month

Examination date year

Programme or Examination Title

Level

Result grade

Awarding Body

Examination dates month

Examination date year

Programme or Examination Title

Level

Result grade

Awarding Body

Examination dates month

Examination date year

Programme or Examination Title

Level

Result grade

D. Work experience

Please give details of your three most recent periods of employment

Employment 0ne:

Job Title

Name of Company or organisation

FT/PT

From (mm/yyyy)

To (mm/yyyy)

Employment two:

Job title

Name of company or organisation:

FT/PT

From (mm/yyyy)

To (mm/yyyy):

Employment three:

Job title:

Name of company or organisation:

FT/PT

From (mm/yyyy):

To (mm/yyyy):

E Payment details:

I am unwaged

I am paying my own fees

My employer/sponsor is paying my fees

Name of employer/sponsor:

Address:

Town/city:

Postcode:

Telephone:

Please note that if your sponsor fails to pay you will be personally responsible for payment.

F Supporting Information

I am attaching a separate sheet:

G Special needs

Do you have Special needs?

If yes, further details to be submitted in writing.

H Declaration

Do you have any criminal convictions, excluding motor offences?

If yes, further details to be submitted in writing.

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Unodd Prifysgol Fetropolitan Abertawe a Phrifysgol Cymru Y Drindod Dewi Sant yn 2012. Mae adroddiad adolygiad Asiantaeth Sicrhau Ansawdd ar gyfer Addysg Uwch prifysgol Fetropolitan Abertawe ar gael yn:
www.qaa.ac.uk/InstitutionReports/Pages/Swansea-Metropolitan.aspx