Faculty of Business & Law

Application Formfor

Postgraduate and Professional courses

Please fill in all sections using BLOCK CAPITALS and typescript or black ink for clarity and ease of copying and return it to James Clark, Faculty of Business & Law, Leeds Beckett University, Rose Bowl Campus, Room 421, City Campus, Leeds LS1 3HB Tel: 0113 812 7550 E-mail:

* Delete as necessaryPlease do not write in any shaded boxes.

1. Personal details

Surname / family name: / Title / Mr / Miss / Mrs / Ms / Dr / other*:
First / given names: / Sex / Male / Female *
Date of birth: / Day / month / year (eg 25/12/82): / Any previous surname
If a student previously at Leeds Met / Beckett, Student ID number: /

Previous Leeds Met / Beckett applicant number, if any

Nationality: /

Country of birth

If not born in the UK, date of first entry to live in the UK: / Day / month / year (eg 10/08/97):
Do you have an unrestricted right to live in the UK? / Yes / No *
Who is expected to pay your fees?

Do you have a Disability / special needs? (see Notes for Completion)

/

Yes / No *

If Yes, please briefly describe the nature of your disability. Ifit is necessary, please give details of any support you might need

Do you have any criminal convictions that are not spent?

/ Yes / No *

2. Contact details

/

Correspondence address

/

Home address – permanent residence (if different)

Address:
Country:
Postcode (UK only):
Landline telephone number:
Mobile number:
E-mail address:
Dates living at this address:

3. Course(s) applied for (please tick one option)

Course title: / Full-time (FT), Sandwich (SW) or
Part-time (PT) ? / Date course starts:
/ Please tick one box only:
MSc in Executive Leadership (Army Cohort) (MSCEX) / PT / 3Oct 2017 / 
Applicant's signature:Date:

4. Qualifications

/

Military qualifications

/

Non-military qualifications

Please give details of your highest qualifications to date, both inside and outside of the Army, including the date awarded and awarding institution:
Please alsoinclude details of your highest English Language qualification below:

Highest English Language qualification type:

/

Level (eg. O Level, GCSE, A Level):

/

Date passed:

5. Ethnic Origin (UK applicants only)

This section of the form is designed to collect statistics so that the University can monitor the effectiveness of its equal opportunities policies. It will be detached before your application is considered. If you are from the UK please enter in the box below the code for the description which most closely matches your ethnic origin.
White
British11
Irish12
Other white background19
Black or Black British
Caribbean21
African22
Other black background29 / Asian or Asian British
Indian31
Pakistani32
Bangladeshi33
Chinese34
Other Asian background39 / Mixed
White and Black Caribbean41
White and Black African42
White and Asian43
Other mixed background49
Other ethnic background80

Code