PROFESSIONAL COURSE

30-Week Course Application

Application Form

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Title *

Name *

First

Last

I like to be called

Email *

Date of birth *

Nationality *

Marital status

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Telephone

(If outside UK, include country code)

Photograph *

Click or drag a file to this area to upload.

A digital passport style photo of yourself

Details of education and qualifications *

Details of previous work experience *

What do you plan to do after the course? *

How do you plan to finance the course & living expenses? *

Self
Parent/legal guardian
Corporate/government sponsor
Other (please specify)

Names, telephone numbers and email addresses of three referees

Please note that your referees must have known you for at least three years and not be related to you.

Referee Name 1 *

Telephone 1

(If outside UK, include country code)

Email 1 *

Referee Name 2 *

Telephone 2

(If outside UK, include country code)

Email 2 *

Referee Name 3 *

Telephone 3

(If outside UK, include country code)

Email 3 *

Give details of any medical conditions of which the school should be aware

How did you hear about the Chippendale International School of Furniture? *

Give any additional information in support of your application

DECLARATION

I declare that the information given in this form is correct

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Signature *

Please sign digitally by entering your details above

Date *

The information given on this form is treated in the strictest confidence

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