Winston School of Art and Technology

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Select Course

Please select Course of Study Proposed :

Has this application been discussed with a member of academic staff?

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If yes give a name :

Proposed date of commencement :

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Full-Time Part-Time

Personal Information

Family Name :

Other Name (if any) :

Address for correspondence :

Postal Code :

Day Telephone :

Evening Telephone :

Fax :

Email :

Date of Birth :

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Nationality :

Country of permanent residence :

If from overseas and currently residing in the UK please mention state the date and conditions of residence stated on your Passport or Visa :

Finance

How do you propose to finance your course of studies here?

Private Means	Post Graduate Award
Employer	Other

Please give the name and address of the person or organisation responsible for paying your fees

Education

(please mention School leaving, Higher Education or any English language courese taken in order)

Title of Degree/ Qualification	Grades	Institution / Awarding body	Year

Professional Qualification

Title of Qualification

Date

Year

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Employment History

Please give details of previous employment

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Designation/ Nature of Job :

Start Date :

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End Date :

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Declaration

I certify that the information given is correct and hereby undertake, if admitted as student of Western School of Art & Techonology, to comply with all ordinance and regulations of the institute.

I also agree for my application documents to be sent to the appropriate university for admission.

I agree to the above terms.

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