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                                                                            Mary O’Connor
                                                                             School of Arts
                                                                       Digby Stuart College
                                                                    Roehampton University
                                                                         Roehampton Lane
                                                                                    London
                                                                                SW15 5PH
                                                                           United Kingdom
                                                              m.oconnor@roehampton.ac.uk
                                                                    Fax: +44-208-392-5028



Pre-sessional English course application
1   APPLICATION FOR:
    Year                                      8 week course
    12 week course                            4 week course


2   PERSONAL DETAILS
    Family name /
    Surname:
    First name(s):

    Male/                    Date of Birth:                    Age:
    Female:
    Contact address:




    Permanent address if different:




    Telephone number:

    Mobile number:

    E mail address:

    Nationality:

    First language:
3   YOUR ENGLISH LANGUAGE LEVEL
    Test (IELTS/                                    Date of               Overall
    TOEFL etc.):                                    test:                 score:
    Scores in all
    sections of the
    test:

4   FUTURE STUDIES
    Do you have an offer to                What degree course are
    study a degree course at               you planning to do after
    Roehampton? (yes/no)                   the pre-sessional?
    What level is this course? (Tick one      Undergraduate:            Postgraduate:
    box)
    Is your offer conditional on         What IELTS or TOEFL
    your English language?               score does your condition
    (yes/no)                             specify?

5   ACCOMMODATION (Tick one box)
    I would like information about accommodation.
    I do not require accommodation.

6   AGENT INFORMATION
    Are you making your application through an agent? (yes/no)
    If yes, please give the name, address and email address of your agent in the
    space below.




7   DOCUMENTS Please tick to show you have included the following:
    A copy of your English test result
    A copy of your Roehampton University offer letter (if applicable)

				
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