1. Personal Details

Family name as appears in passport:

First name(s) as appears in passport:

Title (Mr/Mrs/Miss/etc):

Previous family name (if applicable):

Date of birth:

Gender:

Home/permanent address: Postcode: Country: Tel no.: Mobile: Email:

Correspondence address or address of University Representative (if different): Postcode: Country: Tel no.: Mobile: Email:

Nationality (if dual please give both):

Country of birth:

Country of permanent residence (if UK give County/Borough):

Entry date to UK:

2. Course title.

Course of study:

Start Year:

Point of entry (i.e. year 1, 2 or 3):

Mode of Study:

3. Previous and present education.

Please list details of all institutions attended since age 11:

Name and Address of Institution:

From (mm/yy):

To (mm/yy):

Study Mode (PT/FT/DL*):

4. Academic qualifications - examinations achieved.

Please provide a complete list of all your educational qualifications, including those still in progress, in chronological order

From (mm/yy):

Awarding body:

Subject:

Qualification:

Results achieved:

5. Academic qualifications - examinations pending.

Complete this section only if you are awaiting the result of any examination taken recently.

Exam date (mm/yy):

Awarding body:

Subject:

Qualification:

6. Work experience. (if applicable to course application).

Please give details of work experience, training and employment.

Dates from
(mm/yy):

Dates to
(mm/yy):

FT/PT:

Post held:

Organisation name
and address:

Brief description of
duties:

7. Finance and fee status.

As part of the registration process, students offered a place are required to submit details regarding their financial situation. This information is used to assess eligibility for financial support programs and ensure all students have the necessary resources to complete the course.

Who will be paying your fees?

Please give details

Please give details of any scholarship grant application giving name, value and duration.

Please give details

8. Declaration of a criminal conviction.

Only complete this section if you are applying for a course that requires a Disclosure and Barring Service (DBS) check, which can be confirmed by checking the course entry requirements on our website.

Please indicate if you have a relevant criminal conviction.

Having a criminal record will not automatically disqualify you from applying. We assess all applications on their merits, and the relevance of any criminal conviction will be considered later in the process.

9. Disabilities/special needs.

Check any boxes that apply regarding disability support you may need. In the space below, feel free to detail any additional support or facilities you might require at the Business School. All information you disclose about your disability will be kept confidential and used in accordance with the Business School Policy.

Please select any disabilities/special needs:

I am in receipt of the Disabled Students’ Allowance.

I am applying for or intend to apply for the Disabled Students’ Allowance.

Please detail below any additional support, adjustments or changes you may need for your studies:

How did you hear of County Business School?

Declaration

In order to review your application, the Business School needs to process some of your personal information. To ensure this processing complies with data protection laws, we require your consent. By signing below, you confirm your agreement to the Business School processing your data for application review purposes. This may include sharing some information, including special category data, with UK Visas and Immigration (UKVI) as required by law to verify your immigration history. We understand program selection is important. If you don't quite meet the entry requirements for your chosen course, we may consider you for a similar program at County Business School (CBS) that aligns with your qualifications and interests. This ensures we can still offer you a valuable learning experience. By submitting your application, you'll be providing us with personal data, including some sensitive information. This data is used solely to process your application and may be shared within relevant departments at CBS to ensure a thorough evaluation. We are committed to protecting your privacy and adhering to all data protection regulations. I acknowledge that I have read and understood the School's statement regarding the use of my personal data. I confirm that the information provided is accurate to the best of my knowledge. I am aware that any deliberate misrepresentation of information may result in disciplinary action, up to and including withdrawal from my course.

Your Signature:

Date:

Please return completed applications to: County Business School, 31 Thomas Street London SE18 6HU, UK at https://countybs.com/ or email to:info@countybs.com.

Application Form Please complete the below form and return to