CBT Undergraduate Taster Course Application Form

CBT Undergraduate Taster Course Application Form
Which year in May, would you like to start the UG Taster Course?*

1. PERSONAL DETAILS
Name*

First NameLast Name
Date of Birth*

DayMonthYear
Date
Address*

Street Address

Street Address Line 2

Town/CityCountry

Postcode
Telephone*
Please enter a valid phone number.
Landline

Area CodePhone Number
Email*
example@example.com
Church Denomination or tradition (if applicable):
How did you hear about this Taster course?
Why do you wish to study at Queen’s?

2. COURSE DETAILS
Have you studied at Queen’s previously, and within the last 5 years?*
Student ID:
Review the Queen’s website and consider the areas of study most interest to you here: https://www.queens.ac.uk/study/admissions/non-sponsorsed
What are you hoping to study after completing the UG Taster Course? Please tick*

HE Certificate (120 credits)HE Diploma (240 credits)BA (360 credits)Not known at this stage
Mode of study*

Part timeFull time

3. ACADEMIC HISTORY
Education gained so far (from Colleges, Universities etc)*
Please include the following: Dates of Attendance, Colleges/Universities Attended, Subject, Awarding bodies/exam boards, Levels or Grades and Dates of Awards

4. ADDITIONAL EXPERIENCE
Additional experience (Include ministries, involvement with your church, local community, and voluntary work)*
Please include the following: Date from and Date to

5. FURTHER SUPPORTING INFORMATION
Do you have any additional learning needs that you would like us to be aware of? Please explain in brief:
Are there other life experiences or circumstances that are relevant to this application that you would like to share?

6. FINANCE AND FUNDING
The Taster Course costs £50. If, after successful completion of the Taster course and application process, how might you fund your HE studies? Please tick the method that best describes your intent.*

Church SponsorEmployer SponsorStudent FinanceSelf-FundedCombined Funding (e.g. Self/Church sponsor)
Other (please specify)

7. DECLARATION
I confirm that to the best of my knowledge, the information given on this form is correct and complete. I give my consent for my personal data to be processed within the terms of the General Data Protection Regulation (GDPR).
Signature*

Clear
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Date*

DayMonthYear
Date
Should be Empty: