Cherwell College Oxford
Pre-University Tutorial College
SHORT TERM COURSES - REGISTRATION FORM
Administration: Frewin Court, Oxford OX1 3HZ (adjacent Oxford Union)
Study Centre: Cornmarket, Oxford OX1 3HZ;
Art Studio: Cantay House, Park End Street, Oxford OX1 1JD
Student Residence: Cherwell House, Osney Lane, Oxford OX1 1BZ
College Oxford
Pre-University Tutorial College
Surname:______
Gender:______
Nationality:______
Mobile No (Student):______
Name, Initials and Title of Parent/Guardian:
______
______
Home Address (BLOCK CAPITALS):
______
______
______
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______
Address for Correspondence:
(BLOCK CAPITALS)
______
______
______
______
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Name of Person who can be contacted in case of Emergency (during the course):
______
First Name(s):______
Date of Birth:______
Age at application: ______
Email (Student):______
Home Telephone No:______
Parents’ Mobile No:______
Home Fax No:______
Email:______
Telephone No (work):______
Fax No (work):______
Email (work):______
Name, address of person or persons or Company responsible for payment of Accounts:
______
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Name of your School (or School last attended):
______
Are you considering Oxford or Cambridge? Y/N
Are you wishing to read Medicine or Law? Y/N
Administration: Frewin Court, Oxford OX1 3HZ (adjacent Oxford Union)
Study Centre: Cornmarket, Oxford OX1 3HZ;
Art Studio: Cantay House, Park End Street, Oxford OX1 1JD
Student Residence: Cherwell House, Osney Lane, Oxford OX1 1BZ
College Oxford
Pre-University Tutorial College
Please indicate your preferred dates for the course:
From: Until:
Please indicate the course in which you are interested:
☐Art
☐Drama
☐Academic
☐Business for Life
If applying for the Academic Programme, please indicatelevel,exam boards and unit numbersof subjectsin which tuition is required:
1.______2.______3.______4.______
Fees
Residential (full board, seven nights): £1,375
Additional individual tuition: £65 per hour
Additional night’s accommodation: £60
Is accommodation required? Y / N
The extra-curriculum upon student’s request to be charged separately
Please inform us of any welfare issues (existing medical conditions, dietary matters) regardless of whether or not you are boarding with us, so we can provide appropriate care during your stay.
I enclose a cheque (made payable to Cherwell College Oxford) for £...... …. relating to fees as shown above. Card payments can be made by telephoning our Bursar: 01865 242670.
I am fully aware that this sum is non-refundable should, for any reason whatsoever, I decide not to take up my place on the course.
NOTE: As places are strictly limited (the course is invariably over-subscribed) full fees must be paid at the time of registration.
Signed (pupil)______Signed (parent)______Date:______
Kindly return this Form of Registration with full settlement of fees for the appropriate period immediately you have made a decision to enrol as our numbers are strictly limited. Your registration will NOT be processed if the fees are not received.
Please note that Cherwell College Oxford reserves the right to cancel any particular course that is undersubscribed. However, in that instance, students will be given the option of the equivalent amount of one-to-one tuition in their chosen subject or a full refund.
Administration: Frewin Court, Oxford OX1 3HZ (adjacent Oxford Union)
Study Centre: Cornmarket, Oxford OX1 3HZ;
Art Studio: Cantay House, Park End Street, Oxford OX1 1JD
Student Residence: Cherwell House, Osney Lane, Oxford OX1 1BZ