Wallace College - Full-Time Study Application Form 2010-11

How To Complete This Form

To complete the form, use the Tab key to move from one field to the next, or click on a field to select it. Once you have completed the form, you can send it to us by clicking on the button marked 'Send'. The button marked 'Clear' removes any entries you have made, should you wish to start again. Both these buttons are located at the foot of the form.

Personal Details
Student's full name:
Date of birth:
Nationality:
Home Telephone Number:
E-mail address:
Home address:
Full names of parents / guardians:
 
Profession of parents / guardians:
 
Address (if different from above):
Work Telephone Number:
Mobile Telephone Number:
Name and address of last school:

 

Please list examination results indicating the level and the grades obtained.
Subject Level Grade

 

Please give details of the courses you wish to follow at Wallace College.
Subject Level Exam Board Exam Date *
* e.g Summer 2011 - the exact date is not needed

 

Do you wish the college to arrange accommodation for you?

Yes       No

 

      

 

Note: Please make sure that you click the Send button only once, otherwise we will receive multiple copies of your application.