Application form

Name
Date of birth
Email
Telephone
Address
Post code
Education
Teaching experience (if any)
Work experience
Languages
Mother tongue
Other languages
Any significant medical history or disability we should be aware of that may affect your ability to complete the course (eg. hearing or sight problems)?
Do you have a criminal record?	yes no
How did you find out about this course?
Courses required	Please register me on...
Free introductory seminar First choice:
Second choice:
Intensive certificate course First choice:
Second choice:
Part-time certificate course
Fast track certificate course
Comments
Course fees
Intensive / Fast Track / Part-time TCL Certificate Course	£845.00
Trinity College Moderation Fee	£120.00
If, in the event of needing to repeat or transfer to another course, a 60% repeat or transfer fee plus a new moderation fee will be charged. Transferring and repeating are at the discretion of the tutors.
I require accommodation in Woking / Royal Holloway, Egham	yes no
Note: Deposits are non-returnable, unless the course is cancelled or your application is unsuccessful. Balance of course fees are payable to ULT Limited three weeks prior to commencement of the course. The course fees, less the deposit, are refundable up to three weeks before the commencement of the course. Otherwise fees are not refundable but can be transferred to a subsequent course. Course and moderation fees are reviewed annually and are therefore subject to alteration.
I have read the above information and I agree to be bound by the assessment of my tutors and abide by the course directions. I confirm that the information and claimed qualifications given on this application form are true. It has been clearly explained to me that the Trinity TESOL course, which I am about to take, is a demanding course whether taken as an intensive or part-time option. It involves good time management and dedication to achieve a successful outcome.
I agree	yes no
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