Leading to LLB of Bradford University Law School, Uk

Please fill all sections in BLOCK CAPITALS using black ink for clarity and ease of copying and return to EBS at:

2nd Floor, NACCIMA HOUSE, 8A Oba Akinjobi Road, GRA, Ikeja-Lagos. Tel: 01-7414946, 01-7612221, 07030821555-7

DIPLOMA IN LAW

Leading to LLB of Bradford University Law School, Uk

Please do not write in any shaded boxes

* Delete as necessary / Reg No:
1. Personal Details
Surname: / Title: Mr/Mrs/Ms/Dr/Others
First Name: / Middle Name:
Date of Birth (Day/Month/Year (eg 23/06/63): / Previous Surname:
Nationality: / State of Origin
2. Sponsor’s Details: Please note that your sponsor will be notified periodically of your academic performance
Who is expected to pay your fees? / Name:
Address:
Relationship: / Telephone No:
3. Contact
Please indicate preferred address:
q  Business
q  Home / Business Address: / Home Address:
P O Box
Telephone Number
Fax Number
E-mail Address
4. Course Applied For:
Course Title: / Month & Year Course Starts (eg Sept 2007) / q  Weekday (WD)
q  Weekend (WE)
How did you find out about EBS and this course?
Please tick as applicable:
q  School/College
q  Friends/Family
q  EBS Student (Name) / q  Advertisement (Name of Newspaper)
q  EBS Staff (Name)
q  Others (Specify)
5. Educational Institutions attended (excluding Primary School)
Name of School, Polytechnic or University / Location, including State,& Country
(eg Ibadan, Oyo State, Nigeria) / From / To
Month / Year / Month / Year
1
2
3
4
5
6. Qualification: Please enter your qualifications in chronological order, starting with the earliest. Continue on a separate sheet if necessary.
Institution (No. as in section 5) / Month / Year / Awarding body (if not the Institution where studied / Level/Award (eg GCE, OND, BSc) / Subject /Area of specialization
7. Work Experience: Please enter details of your employment history in chronological order, starting with the earliest
Name & Location of Organisation / Position/Job Title / Type of work/duties / From / To
Month / Year / Month / Year
8. Personal statement in support of application
Please enter here any further information you may wish to offer in support of your application. We are particularly interested in your reasons for choosing the course for which you are applying, your career aspirations and other information relevant to your application which you have been unable to provide elsewhere on this form. If you have been out of formal education for some time, please outline any relevant experience that may be taken into account in lieu of formal qualifications.
9. Criminal Convictions
Do you have any criminal records? Yes/No*
10. Applicant’s Declaration
I confirm that the information given on this form and in any accompanying documents is true, complete and accurate. I have not omitted any information requested or other material information. I accept that, should this prove not be the case, the EBS reserves the right to cancel my application and I shall have no claim against it in relation thereto. I give consent to the processing of my data by EBS and any other organisation which has a statutory right to receive any of it.
Applicant’s signature: Date:
11. Reference
Reference for (Name of applicant):
(a) Name of Referee: (Academic - Present or Previous Lecturer/Teacher)
Post / Occupation / Relationship to Applicant:
Name of Institution / Organisation:
Address:
Telephone: / Fax: / e-mail:
(b) Name of Referee: (Present/Previous employer)
Post / Occupation / Relationship to Applicant:
Name of Institution / Organisation:
Address:
Telephone: / Fax: / e-mail:
12. Other Information
Have you been to the UK before?
Do you have a valid UK Visa?
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