DL Booking Form PD by bKvSFpe


Module Booking Form
Programme: Professional Development

Title:                Forename:                                                Family name:

D.O.B:                                 Nationality:                                 Student Registration No:

Delivery Address:
PLEASE NOTE this must be a physical address. Deliveries WILL NOT be made to P O Box numbers.

                                                                               Postal Code:

Email:                                                                         Contact Telephone No:

                                                                                   START                                         MODULE
CODE              MODULE TITLE                                                                      END DATE           FEE (£)
                                                                                   DATE                                          CHOSEN

CVP280            Emergencies Management and People                                15-January       15-June          £1,050.00
CVP282            Emergency Sanitation                                             15-January       15-June          £1,050.00

CVP262            Environmental Assessment                                         15-January       15-June          £1,050.00

CVP269            Solid Waste Management                                           15-January       15-June          £1,050.00

CVP258            Urban Infrastructure                                             15-January       15-June          £1,050.00

CVP252            Water and Environmental Sanitation                               15-January       15-June          £1,050.00

CVP265            Water for Low Income Communities                                 15-January       15-June          £1,050.00

CVP273            Water Utilities Management                                       15-January       15-June          £1,050.00

CVP281            Emergency Water Supply                                           15-July          15-December      £1,050.00

CVP268            Integrated Water Resources Management                            15-July          15-December      £1,050.00

CVP283            Introduction to Infrastructure in Emergency                      15-July          15-December      £1,050.00

CVP272            Low-Cost Sanitation                                              15-July          15-December      £1,050.00

CVP251            Management of Water and Sanitation                               15-July          15-December      £1,050.00
CVP257            Wastewater Treatment                                             15-July          15-December      £1,050.00

Deferral / Re-sit - cost per module
(If booking a reassessment you must also return a reassessment form)                                                   £75.00

The fee is inclusive of postage / courier charges
                                                                                                 TOTAL AMOUNT PAYABLE

                                    Water Engineering and Development Centre (WEDC), Loughborough, Leics, LE11 3TU
                                                 Fax: +44 (0)1509 211079 E-mail: wedc-admissions@Lboro.ac.uk
                                                   PAYMENT OPTIONS

[ ]            I enclose a sterling CHEQUE drawn on a UK bank account made payable to ‘Loughborough

[ ]


               The online payment system provides an easy, flexible method to enable you to pay tuition fees owing.
               The University will accept payment in sterling only from the following cards:

               Visa Delta MasterCard Solo Maestro

               You will need the Student Identification Number, student name and date of birth in order to use this
               I would like to pay by CREDIT CARD Visa/MasterCard (Delete as appropriate) A 1.2% Fee applies
[ ]
               Start date: ..……..…………...Expiry date: ……………. ….Issue no: …………..……

               Card number: ………………………………….……………..……………………………

               Security Code: ………… ………………(last 3 digits printed on card signature strip)

               I am arranging a BANK TRANSFER to:
[ ]
                Account Name             Loughborough University
                Bank                     Barclays Bank Plc, Bishop Meadow Road Branch,
                                         Loughborough, Leics, LE11 5RB United Kingdom
                Sort Code:               20 - 52- 69
                Account Number           50682047
                IBAN:                    GB73 BARC 2052 6950 6820 47
                SWIFTBIC                 BARCGB22
               Please make sure you pay all bank charges at the time the transfer is arranged to avoid a shortfall
               on the amount due. Ensure transfer documents show your FULL NAME and if applicable the
               student identification which will enable your payment to be identified and allocated accordingly.
               Please advise wedc-admissions@Lboro.ac.uk when the transfer has been processed by your bank.

[ ]            If you are to receive an award from a sponsor and require an INVOICE to be raised please contact
               wedc-admissions@Lboro.ac.uk at an early stage who will be able to arrange this.

 Modules starting 15 January                                     1 DECEMBER
 Modules starting 15 July                                        1 JUNE

                        Water Engineering and Development Centre (WEDC), Loughborough, Leics, LE11 3TU
                                 Fax: +44 (0)1509 211079 E-mail: wedc-admissions@Lboro.ac.uk

     Materials are issued on a 'first come first served' basis to students who have
      by the booking deadline as only a limited number of module packs are
      available for each session

     Where booking conditions have been met materials are guaranteed to arrive
      in or before the week leading up to the session start date unless otherwise

     Delivery dates are only guaranteed if booking deadlines have been met

     Bookings and payment received later than the booking deadline will only be
      processed if sufficient materials are available for the module(s) chosen

     Students who book modules after the stated deadline will not be able to use
      late receipt of materials to make impaired performance claims, late
      submission or deferral requests

     In all cases materials will only be released once payment has been verified by
      the University Finance Office

     For cancelled bookings, payment will be refunded but an administrative
      charge of 10% will be deducted

         Water Engineering and Development Centre (WEDC), Loughborough, Leics, LE11 3TU
                  Fax: +44 (0)1509 211079 E-mail: wedc-admissions@Lboro.ac.uk
You should nominate a local guarantor who occupies a position of authority, for
example your sponsor, employer, manager or supervisor. The guarantor’s
responsibility is to confirm that each assignment you submit (up to three per module)
is your own work. If they feel able to provide other support such as advice or
response to technical queries, then that too will be helpful though not essential. Your
guarantor should know you well and be available before the submission deadline to
countersign each assignment. S/he cannot be a member of your family.

Before nomination, you should discuss arrangements for counter-signature of
assignments with your proposed guarantor.

If you are offered a place on a WEDC programme we will then contact your proposed
guarantor to ask them to complete a slightly more detailed form. If they need further
information, please ask them to contact WEDC’s Admissions Administrator:

Applicant’s name:

Details of your proposed Distance Learning Guarantor:


Position in company/government/organisation:

Address of place of work relating to the position stated above (preferably a
physical address not a PO Box):




Proposed Guarantor’s Signature:


           Water Engineering and Development Centre (WEDC), Loughborough, Leics, LE11 3TU
                    Fax: +44 (0)1509 211079 E-mail: wedc-admissions@Lboro.ac.uk

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