The BKA Foundation Course Application Form

Part One - University of Huddersfield

Friday2nd March 2018: 18.00 to 21.00

Saturday 3rd March 2018: 10.00 to 17.00

Part Two - Telford Campus, University of Wolverhampton

Saturday 7th April 201810.00 to 17.00

Sunday 8th April 201810.00 to 17.00

YOUR DETAILS:

NAME…………………………………………………………………………………………………Date of Birth………………………..………..………

ADDRESS……………………………………………………………………………………………………………………………………………………..………

POSTCODE………….…………….………..……TEL………………………………………………MOBILE……………………………….………..….…

EMAIL……………………………………………….………………...... ………..……….………………………………………..………………………….
Musical Experience if any (no previous experience required for the course) ……………………………………………………….
…………………………………………………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………………………………………………

A DIRECTORY of participants will be made available to all students on arrival.

NB. The BKA does not disclose your details to any other organisation.

May we include the following:[Please circle as appropriate]

Name? Yes No Address? Yes No Telephone? Yes No Email? Yes No

FILMING/PHOTOGRAPHY

Activities may be photographed / filmed for the documentation, evaluation and promotion of the work of the BKA. May we have your consent to being photographed/filmed? Yes No

Are you a FULL TIME STUDENT? Yes No NB. All applicants must be 18 years or older.

If yes, please give your place of education………………………………………………………………………………..…………………………..

What is your occupation?

If you are a teacher, please indicate the type of school where you teach. [Please circle as appropriate]

Public Private Pre-school Primary

YOUR REQUIREMENTS: (If opting for residential Accommodation in Telford)

DIETARY REQUIREMENTS. Please state special dietary requirements if needed. [Please circle as appropriate]

Vegetarian Vegan Gluten-free Other Please provide details

MEDICAL AND ACCESSIBILITY ISSUES. Do you have any special needs, learning disabilities, medical requirements or any access issues, e.g. mobility, visual, aural, that we should know about? If so, please provide details here.

PAYMENT

All charges include any applicable VAT and are quoted in pounds sterling; payment cannot be accepted in any other currency. I am applying for the following course: (Please tick as appropriate)

A / Huddersfield only (non certificated) / £90
B / Telford only (non certificated) / £109
C / Certificated Course : Attendance at both weekends is compulsory / £199

NB (i) Payment must be complete by 2nd March 2018 (start date of course) unless an earlier date is shown above.

(ii) A deposit of £50 is required to secure your booking (not refundable if cancelled after 31st January).

(iii Accommodation is not included in the above costs. In Huddersfield students will be responsible for the booking of

accommodation. In Telford there in an option of a Supper, B and B package at the university for an extra £59 –

alternatively participants may make their own arrangements

The £ amount I am paying at the time of this application is (please circle the relevant figure):-

Payment methods:

Cheque Please make cheques payable to ‘British Kodály Academy’ and enclose with this form.

BACS or card To pay by BACS, or by credit or debit card, please contact BKA Treasurer, John Oliver.

Telephone 024 7641 1269 or email

Signed ______Date ______

Please send your completed application form AND your cheque (if applicable) to:

Lucinda Geoghegan, Course Administrator, 32 Kirkfield View, Livingston Village, Livingston, West Lothian, EH54 7BP

OR email Lucinda at