Evening and weekend courses enrolment form 2010/11

Enrol now using this secure enrolment form. For your protection, we have installed the online payment verification process recommended by your bank or card provider (eg. MasterCard SecureCode). Your payment will not be authorised without this verification.

PLEASE NOTE: VISA DEBIT CARD USERS

If you receive an error message when you try to pay, please select 'Delta' from the list and try again. If your payment still doesn't go through, please call us on 020 7040 8237/8865; for Translation courses call us on 020 70408266 between 09:30 and 17:00 or email translation@city.ac.uk.

Alternatively, you may enrol by posting a printed version of the enrolment form. Send your completed enrolment form, together with your cheque or credit/debit card information, to: Evening and weekend courses, City University, Northampton Square, London EC1V 0HB.

Business, Computing courses: 020 7040 8865

Languages, Writing, Creative Industries courses: 020 7040 8237

Translation courses: 020 7040 8266

Fields marked with a * are required.

Need help with this form? Let us help.

Section 1: CONTACT DETAILS

Forename *

Surname *

Title *

Other *

Address

House number/name *

Street *

Town

City / County *

Country

Postcode *

E-mail address *

Contact number (Daytime) *

Section 2: PERSONAL INFORMATION

Date of Birth * DD/MM/YYYY

Gender * MaleFemale

Section 3: HOW YOU HEARD ABOUT CITY

How did you find out about this course? *

(If Other) Please specify where you heard about City

Section 4: COURSE DETAILS

	Course Title	Course Code	Start Date	Course Fee
*

For TRANSLATION COURSES only:

Language Options:

Section 5: Accreditation

Have you taken a short course with City University London and acquired credits in the academic year 2008/09? * YesNo

From 2009/10, accreditation is not available unless you have taken evening or weekend courses at City University London in the last four years. If you have taken a course at City University London in this period and would like to continue to receive credits, there is a cost of ??150 per 10-credit module. We will bill you separately for the accreditation fee, if you would like to receive accreditation for the course(s) selected above and consent to paying ??150 per 10-credit course. Simply select "Get Accredited" below. Get Accredited

If you do not want to receive future information regarding short courses please tick this box:

If you are ready to send your enrolment to Courses for Adults, please indicate your agreement to the following statement:

"I hereby agree to abide by the rules and regulations of the University, including the refund policy. I agree to the University processing personal data contained in this form, or other data which the University may obtain from me or other people whilst I am a student, for purposes connected with my studies, my health and safety or any other legitimate reasons. I confirm that I have read, and agree to, the Terms and Conditions of enrolment."

I agree to the above statement. * Yes