Application form


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Application form

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Please print clearly in English in BLOCK LETTERS. Tick boxes where appropriate. Please read carefully and send the completed application form to ACBT. Certified

academic transcript, certificates and proof of English proficiency (eg: must accompany your application.

IELTS, TOEFL

etc.)

Your application will not be processed if you do not provide all the requested details.

Previous studies

l

Student No:

)

Secondary education: highest level achieved

Personal details 1

[tle: r:rr. f]y: l,l y:_ i-1y5:

I other '

(e.g. Year 12, HKALE,

A

Levels):

i--

] Family name:

,l

I Given names:

i_cgtpr*"di l_lJ":

I

]

Preferred name:

! Language of

I

I

lIIg

instruction:

Name of qualification (e.g. degree, diploma): Name of school/institution:

Country/stdte:

Completed: I Haveyou previouslystudied atACBT?

[ves

I

Yes

l*]No

lf 'yes', please provide your ACBT student lD number: I :

Employment history Do you grant ACBT permission

lf you believe you have employment experience that b relevant to the program you are appMng for, please attach a CV and

to provide your parent or

guardian listed below with any information pbrtaining to

references.

your application to study, ongoing academic progress, results and attendance?

l*] Yes I_l t to

Program selection

I

Contact details

ufP certificate

University-level (Diploma) program

Applicant's contact details

l*-] Oiploma of Business t-.1

?iplgr" .t lgmouting

Please specify when you prefer

to begin your studies:

Iruarch f].lrty

l__]November

Request for disability support Do you have a disability

that may affect your studies?

| iVes l-l tto

lf 'yes', please specify: Please attach relevant

Pa

!

rent's/gua rdia n's contact details

information so that,ACBT can arrange assistance

:

English proficiency

Family name:

(Please tick and attach documentary evidence where

iGiven names:

il ;

English is my first

applicable)

:

language. :

EnSlish was

the language of instruction during my secondary school

studiesandlgainedasatisfactorypassinfinal-yearEnglish.

1lhavetakenanlELTSorToEFLtest(attachresults). Home telephone:

examination

:

(e.g. completion of at least the first year of a post-secondary/tertiary course at a

i

;

or test acceptable to ACBT

l

_:_l Business telephofre: I

_l

I have obtained a satisfactory mark or score in another

i

] college or university where the language of instruction was English). ] IELTS (Acadqmic)

orTOEFLscore: .|-_

I

Other information i How did you first learn about

ACBT? You may

I rxhibition/seminar I l] ru"*tprper/magazine ;I ;Recommendedbyafriend/relative-if , I I Recommended bir an education agent

tick more than one.

,

1r ];

I

,]

so,isyourfriend/relativeaACBTstudent? IYes INo

nternet, please specify:

other (please specify):

Application checklist 1

Check that you have:

I I

completed all sections of the Application form read and understood the Conditions of Enrolment page 25

Check that you have attached:

!_] certified copies

of your academic qualifications

I

evidence ofyour English language proficiency (if required)

i- i

a copy of

your passport, visa or birth certificate (if required)

i*-j .ny relevant employment documentation (if required)

I-l

certified translations o[any documents not in English

A certified copy is signed by an authorised officer to acknowledge that it matches the original document exactly. Authorised officers include

Declaration I declare the information I have supplied on this form is, to the best of my understanding and beliel complete and correct. I understand that giving false or incomplete information may lead to.my application being refused or my enrolment cancelled. I have read and understood the relevant program information in this brochure and/or on the ACBT website and I have sufficient information about ACBT to enrol. I understand that the pathway may lead to future studies at ECU, subject to ECU'5 entry requirements. I understand that ACBT fees may increase. I accept liability for payment of all fees as explained in the ACBT brochure, and I agree to abide by the Refund

policy as specified on page 26. I have understood and I accept the Conditions of Enrolment on page 26. I understand that ACBT may, by written notice, vary its conditions as may be necessary to comply with any law or regulation, or amendment of any law or regulation, of the.Republic of Sri Lanka. I give permission for ACBT and ECU to obtain official records from an educational institution attended by me, and to supply my contact details and any relevant official records to educational institutions I am eligible to gain admission to. lauthorise ACBTto provide my personal information, including my contact details and enrolment details, to third parties in accordance with ACBT's Privacy policy. These third parties include ACBT representatives (agents) acting on my behalf; ECU (to facilitate progression from ACBT to the next stage of my studies); and Navitas Limited and its affiliates (to communicate regarding pathways and services offered by Navitas Limited and its related companies). I understand that any conditions concerning an offer of admBsion will be contained in my letter of offer from ACBf,, which I will be required to read and

sign.

Parent's/guardian's signature (if applicable)

Applicant's signature

Date: /

Date:l/(day/month/year), lf you are under 18 years of age, your parent or guardian must also sign this application form.

Application submission i This application form has been submitted in: I

i city'

Country:

Postal address for applications ACBT colombo College

ACBT Kandy College

442 Galle Road Colombo 03

3A Mahamaya Mawatha Kandy

Sri Lanka

Sri Lanka

Telephone: +94 11 2565 511 Fax: +94 11 2565 594 Hotline: +94 777 3000 900

Telephone: +94 81 2205 858 Faxi +94 81 2205 17 I

Hotline:+9477 2273333

Email:[email protected] Web: wwwacbt.net OR hand

it in, in person, to the

ACBT reception or

to an

ACBT marketing counsellor.

/

(day/month/yead