CENTRE FOR THE ADVANCEMENT OF LEARNING AND TEACHING

PPMS Application Form

Course: 9th - 11th November 2012, Easthampstead Park, Berkshire.

Welcome to the PPMS online application form. Please complete all fields of the form and we will contact you in due course.

All information is in the strictest confidence and will be used solely for the purposes of administering the PPMS course. It will never be released without permission to any party not involved in the running of the PPMS course.

If you have any questions please send them to ppms@ucl.ac.uk.

Please make sure that you have all the required information available before filling out this form.


| 1 | PERSONAL DETAILS  

Title:

Forename:

Surname:

Preferred Forename:

  

Tel:

E-mail:


Gender:  Male   Female


Date of Birth:   /   / 19  (DD / MM / 19YY)

Term time Address:

Department: 

Degree Type:  Other: 

Date of Registration:   /   (MM / YYYY)

| 2 | MEDICAL DETAILS  

IMPORTANT: Who would you want us to call in case of an accident or emergency?

Emergency Contact Name:

Emergency Contact Number:

Do you have any special Dietary requirements?

Are you taking any medication?

Do you have any physical condition which may affect your participation in the course?

Any other special requirements we should know about?

| 3 | OTHER DETAILS  

Are you on a UK Research Council funded Studentship?
Yes
No

    If yes, which research council?  

A pre-course seminar will be held in 66-72 Gower St, Graduate School Training Suite, Lecture Room (B.09)
at 5:30pm-7:00pm on Wednesday 31st October 2012. Please Indicate if you are able to attend:
I am able to attend
I will not be able to attend

How did you find out about this course? 

Please take a moment to compose a brief statement, in two or three sentences, explaining why you are interested in attending this course and what you wish to accomplish through participating in it.

After completion and submission of this application form, you should receive an email offering an appointment at CALT to receive joining instructions and to lodge a personal deposit of £100, which is returned in full on attendance at the course.

I wish to submit my application, having read and understood the terms and conditions of the deposit policy.

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Terms and Conditions of Deposit Lodgement for Residential Courses

For residential courses a personal deposit of £100 is required to confirm registration. This is reimbursed in full on completion of the course.

After submitting your application, you should receive an email offering an appointment with our staff at CALT to receive joining instructions and to lodge your deposit at room G24, 1–19 Torrington Place. If you don't receive this email within three days of applying, please call 020 7679 1672 (UCL internal 41672), or email ppms@ucl.ac.uk to arrange a suitable time.

To simplify reimbursement, deposits should normally be lodged via credit or debit card transaction. If this is not possible, cheque or cash may be accepted, but reimbursement after completion of the course will take considerably longer to effect. A receipt is issued on lodgement of deposit.

Your personal deposit is accepted in good faith as a commitment to attend and complete the course for which you have registered. Withdrawals from residential courses incur a significant cost, since external venues charge cancellation fees, usually at full accommodation rate – typically £300 per person. We do recognise that exceptional situations such as illness or bereavement can arise unexpectedly, which may prevent or disrupt attendance at the course. If emergencies of this kind arise, we will normally transfer your registration to the next available course on presentation of appropriate supporting documentation. Otherwise, non-attendance will result in forfeiture of the deposit and may incur an additional charge to cover the full cancellation fee levied by the venue.

Graduate School skill development courses are primarily provided for research degree students; but taught Masters students may take up places left vacant at 3 weeks before course start date. Allocation of such vacancies will be in order of application and receipt of deposit.

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