30 APPLICATION FORM Affix a passport

AXIAL INTERNATIONAL COLLEGE – UGANDA
A MEMBER OF THE MK PUBLISHERS GROUP OF COMPANIES
245 TANKHILL ROAD, MUYENGA – KAMPALA
30
P.O.Box 75882, Kampala, Uganda
+256-(0)414-501-791, +256-(0)774-017-187
facebook.com/Axialinternationalcollege
Uganda@axial.co.ug,
Years
www.axial.co.ug
EDUCATING THE WORLD.
Affix a passport
size photo here
APPLICATION FORM
PLEASE WRITE IN BLOCK CAPITALS, PLEASE NOTE, IT IS MANDATORY TO FILL IN BOTH DATE OF BIRTH AND APPLICATION DATE.
1. COURSE SELECTION
HND/Bachelors Degree pathway
Level of study
Pre-MBA/PGD/ Level 7 Edexcel
HNC/International Foundation Year
Performing arts
Business
Law, Management, Marketing, Accounting,
Business, Human resource.
Hospitality Management
Computer and systems development
Media
Programmes
Radio, Moving images, Journalism,
Production, Performance.
Travel and Tourism Management
Music
Production, Performance.
Arts and Design
3D art, Photography, Fashion & Textiles,
Time of study
Full time
Part time/ Flexible
Preferred
Entry Date
February
May
September
Year: 20.........
When will you complete your O/A-level
equivalent?
Please attach additional sheets if more space
is required.
Qualification:
Institution:
Grade Attained:
Year enrolled:
Year completed:
SECONDARY SCHOOL STUDIES
(A Levels)
Please attach additional sheets if more space
is required.
Qualification:
YYYY
To:
DD
MM
YYYY
Institution:
Grade Attained:
Year enrolled:
3. PARENT/GUARDIAN DETAILS
Guardian
Title (e.g Mr/Mrs/Miss/Ms):
First Name:
Occupation
Permanent Home Address.
If yes, please indicate the date your results
will be available:
SECONDARY SCHOOL STUDIES
(O Levels)
Address for Correspondence:
(If temporary please specify dates)
Parent
No
Other ..........................................
2. STUDENT DETAILS
Title (e.g Mr/Mrs/Miss/Ms):
First Name:
Last Name:
Date of Birth: DD MM YYYY Country of Birth:
Gender (M/F):
Marital Status:
Nationality:
(Please attach birth certificate)
Country of Ordinary Residence:
Permanent Home Address.
MM
Are you currently studying? Yes
What is the name of your school?
Art & design, Interactive media, Graphic Design.
Computer Game design, Computer game animation.
From:
DD
Tel No:
(inc. dialing code)
Email Address:
4. EDUCATION
CURRENT STUDIES
Next of Kin
POST SECONDARY STUDIES
(Diplomas/Degrees)
Please attach additional sheets if more space
is required.
Last Name:
Qualification:
Institution:
Grade Attained:
Tel No:
(inc. dialing code)
Email Address:
Address: 245 Tank Hill Road Muyenga
Year completed:
Year enrolled:
Email: Uganda@axial.co.ug
Year completed:
Website: www.axial.co.ug
5. EMPLOYMENT
Are you currently employed?
Yes
No
If yes, what is the name of your employer?
Is your employment
Full time
Part time
6. GENERAL
Do you have any applications to other institutions of higher education currently
under consideration? Your answer will not prejudice you application. Please
specify:
…............................................................................................................................
....................................................................................................................
Do you have a disability(s) we should be aware of?
Yes
No
If yes, details:
................................................................................................................................
....................................................................................................................
Do you have a criminal record?
Yes
No
If yes, details:
................................................................................................................................
....................................................................................................................
How did you hear about Axial International College?
…................................................................................................
....................................................................................................
....................................................................................................
................................................................................
Did you use our website to find out information about the
College before applying?
Yes
No
If yes – did you find all of the information that you needed?
Yes
No
If no then please tell us what you would like to have found.
…................................................................................................
..........................................................................................
7. KNOWLEDGE OF LANGUAGE
English Language Classes (including classes at school)
Total years of study in English within your own country:
Year(s)
Years of study in English abroad.
Name of institution(s) where you studied in English:
Country:
From:
Year(s)
To:
Years of study in English at higher education:
From:
Year(s)
To:
LEVEL OF ABILITY
Language
Excellent
Very Good
Good
Fair
English
Mother tongue
DECLARATION
I understand that:
• Axial reserves the right to discontinue or alter any program, course/subject, fee, admission, requirement, staffing or other arrangement
without prior notice subject to the refund policy.
• I may access my own student records, subject to privacy legislation. For more detailed information on Axial’s privacy policy please
contact Axial International College.
• Tuition fees are to be paid as per the payment schedule that will be included in the offer letter if my application is successful, and tuition
fees will increase if I need to repeat courses, assessment or undertake additional electives that will exceed the minimum requirement.
• My application fee will only be refunded if my application is not successful.
• If an offer of a place is made, it will be conditional upon a face-to-face meeting or a phone call at the request of the Axial advisory team.
• If under 18 years of age then a guardian will be required to sign for you and to present a copy of their identification (passport or
National ID).
I declare that to the best of my knowledge the information supplied in this application and the documentation supporting my application is correct
and complete and that any portfolio, personal statement or additional documents are my own. I acknowledge that the withholding of information
or provision of incorrect documentation relating to my application may result in cancellation of any offer of enrolment by Axial.
Have you completed all sections of the application form and read and understood the declaration?
Yes
No
If you choose to print this form instead of e-mailing it, then the student or guardian must sign (must be 18 years or older to sign)
Signature:
Date:
___________________________________
PERSONAL STATEMENT
“Why I want to study my chosen programme and why I want to study at Axial International College.’’
(To be submitted by all applicants. Please attach a typed answer to the above question with no more than 500 words.)
Address: 245 Tank Hill Road Muyenga
Email: Uganda@axial.co.ug
Website: www.axial.co.ug