Citiedge International College London - Application & Enrolment Form

1

Personal Information

Title*

First Name*

Middle Name(s)

Last Name*

Date of Birth*

Gender*

Male Female Non-binary Prefer not to say

Nationality*

Country of Permanent Residence*

Passport Number*

National Insurance Number (if applicable)

Email Address*

Contact Number*

Current Address*

City*

Postcode*

Country*

2

Course Selection

Programme/Course Applied For*

Mode of Study*

Full-time Part-time Online/Distance

Level of Study*

Undergraduate Postgraduate PhD/Research

Start Month*

Start Year*

Campus Preference

3

Academic History

Please provide details of your previous education (attach transcripts and certificates).

Entry 1

Qualification*

Institution*

Country*

Dates From*

Dates To*

Grade/Result*

Entry 2

Qualification

Institution

Country

Dates From

Dates To

Grade/Result

Entry 3

Qualification

Institution

Country

Dates From

Dates To

Grade/Result

4

English Language Proficiency

English Language Qualification*

Overall Score*

Reading

Writing

Speaking

Listening

Date Taken*

5

Employment History (if applicable)

Position 1

Position

Employer

Country

From (MM/YYYY)

To (MM/YYYY)

Responsibilities

Position 2

Position

Employer

Country

From (MM/YYYY)

To (MM/YYYY)

Responsibilities

6

References

Referee 1

Referee Name*

Relationship*

Email*

Contact Number*

Referee 2

Referee Name

Relationship

Email

Contact Number

7

Funding & Scholarships

How will your tuition fees be funded?*

Self-funded Scholarship Loan Employer-sponsored Other

Are you applying for a scholarship?

Yes No

Scholarship Name (if applicable)

Student Finance CRN Number (if applicable)

If you are applying for Student Finance England funding, please enter your Customer Reference Number (CRN).

7B

Agent Information

Is this application being submitted through an agent or representative?*

Yes No

8

Additional Information

Do you have any disability, health condition, or learning support requirement?

Yes No

If yes, please specify:

Do you have a criminal conviction?

Yes No

If yes, please provide details:

Please provide any other information you think is relevant for your application:

📎

Supporting Documents

📋 Checklist - Please attach the following:

☐ Completed Application & Enrolment Form
☐ Academic Transcripts & Certificates
☐ English Language Test Certificate
☐ Passport Copy / ID
☐ Reference Letters
☐ Personal Statement / Statement of Purpose
☐ Proof of Funding / Scholarship Documents

Upload Supporting Documents (multiple files)

Accepted formats: PDF, JPG, PNG, DOC, DOCX. Max file size: 10MB per file.

9

Declaration

I confirm that the information provided in this application is true and complete to the best of my knowledge. I understand that providing false information may result in the withdrawal of my offer or enrolment. I agree to abide by the rules and regulations of the university upon enrolment.

I agree to the declaration above*

Applicant Signature (Type full name)*

Date*