CSI: Leicester Forensic Science Summer School 2013 Application Form

CSI: Leicester Forensic Science Summer School 2013 Application Form

Please ensure that all sections are completed before the form is submitted to the university. All sections must be completed either electronically, or written in BLOCK CAPITAL letters in black ink. Write as clearly as possible, or you may not receive important post and email updates. Closing date for applications is 01 April 2013.

Completed applications can be emailed to or sent by post to:

CSI Summer School

Department of Chemistry

University of Leicester

University Road

LE1 7RH

Personal Details

Surname (Family name): ______

First Name(s): ______

Title: Mr – Miss – Mrs – Other: ______

Delete as appropriate: MaleFemale

Date of Birth: ___/ ___/ _____

Country of Permanent Residence: ______

Country of Birth: ______

Nationality: ______

Address for Correspondence:Home Address (if different):

Postal Code: ______Postal Code: ______

Telephone Number: ______

Fax Number: ______

Email Address: ______@ ______

Qualifications

University/Institution you are studying at: ______

Degree Program (Major) for which you are enrolled: ______

Current year of study: ______Total duration of study: ______

Current modules undertaken and grade/score achieved:

In no more than 150 words, please describe what you expect to achieve by participating in this course and why it is appropriate for you at this time in your studies?

In no more than 150 words, please describe how you think this course will benefit your degree and subsequent career progression?

English Language

Is English your first language?YESNO

If no, how many years have you been learning English? ______

What qualifications in English language do you have? ______

Fees

The all-inclusive tuition fee will be GBP 1950, which includes accommodation, course fees, tuition and excursions. Without accommodation the fee is GBP 1600

You will be sent specific details how to pay your fees online when we send out your information pack upon successful application to this course.

Criminal Convictions

Do you have any criminal convictions?YESNO

If you have been convicted of a criminal offence (excluding (a) a motoring offence for which a fine and/or the equivalent of a maximum of 3 UK penalty points were imposed or (b) spent sentences), you are required to declare this by completing the ‘yes’ box on your form (above).

Declaration

The University of Leicester holds information about students in order to manage recruitment, admission, registration, study, examination and other student services such as accommodation. Information is passed between various sections of the University for operational reasons (for example, the Registry notifies changes of address to departments, the Library, the Computer Centre and other units on a ‘need to know’ basis). If, at the end of your course, you have unpaid debts to the University, the University may, at its discretion, pass this information on to collecting agencies.

I have read and understand the above Data Protection Statement and I agree to the personal data included in this application form being processed as detailed above.

I certify that the information I have given is complete and accurate.

Signed ______Date ___ / ___ / _____