BA Humanities (part-time) Degree Programme ... - Swansea University

APPliCAtiOn fOrM BA (HOnS) PArt-tiME DEgrEE PrOgrAMME 2012 - 2013
Please note that students will be called for an interview and may be required to supply a written personal statement
in support of their application.
A. PERSoNAL DETAILS
title: mr / mrs / miss / ms / rev / dr / professor
First name(s) _____________________________________ Surname ________________________________________________
home address _____________________________________________________________________________________________
________________________________________________ postcode__________________________________________________
date of Birth country of Birth daytime telephone number (including STD code)
_________________________________________________________________________________________________
evening telephone number (including STD code) ___________________________________________________________
mobile telephone number e-mail address
_________________________________________________________________________________________________
B. EMPLoyMENT STATuS (Please tick appropriate box)
in paid employment retired: private pension retired: State pension
registered unemployed in receipt of other state benefit otherwise unwaged
(e.g. Income support/family credit)
C. CouRSE/VENuE CHoICE
please list the two courses for which you are applying:
course one ________________________________________________________________________________________________
Venue _____________________________________________________________________________________________________
course two _______________________________________________________________________________________________
Venue _____________________________________________________________________________________________________
reserve choice course ______________________________________________________________________________________
Venue _____________________________________________________________________________________________________
N.B. your reserve course choice will automatically be selected if any of the courses you have selected are full or have low numbers.
D. STuDy SkILLS
if you wish to attend a Study Skills course in September at either of the following counties, please tick the relevant box:
Swansea neath port talbot carmarthenshire pembrokeshire
E. PREVIouS EDuCATIoN (From the age of 11)
dates:_____________________________________ name of school/college:__________________________________________
From _________to ___________________________________________________________________________________________
From _________to ___________________________________________________________________________________________
From _________to ___________________________________________________________________________________________
examinations taken (whether passed or failed) or credits gained
examining body examination date Subject grade/result
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
please list any other courses which you have attended in recent years which have not involved any examination or credit
(e.g. evening classes or courses at work).
date name of course organising body
___________________________________________________________________________________________________________
___________________________________________________________________________________________________________
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