AXIAL INTERNATIONAL COLLEGE – UGANDA A MEMBER OF THE MK PUBLISHERS GROUP OF COMPANIES 245 TANKHILL ROAD, MUYENGA – KAMPALA 30 P.O.Box 75882, Kampala, Uganda +256-(0)414-501-791, +256-(0)774-017-187 facebook.com/Axialinternationalcollege [email protected], Years www.axial.co.ug EDUCATING THE WORLD. Affix a passport size photo here APPLICATION FORM PLEASE WRITE IN BLOCK CAPITALS, PLEASE NOTE, IT IS MANDATORY TO FILL IN BOTH DATE OF BIRTH AND APPLICATION DATE. 1. COURSE SELECTION HND/Bachelors Degree pathway Level of study Pre-MBA/PGD/ Level 7 Edexcel HNC/International Foundation Year Performing arts Business Law, Management, Marketing, Accounting, Business, Human resource. Hospitality Management Computer and systems development Media Programmes Radio, Moving images, Journalism, Production, Performance. Travel and Tourism Management Music Production, Performance. Arts and Design 3D art, Photography, Fashion & Textiles, Time of study Full time Part time/ Flexible Preferred Entry Date February May September Year: 20......... When will you complete your O/A-level equivalent? Please attach additional sheets if more space is required. Qualification: Institution: Grade Attained: Year enrolled: Year completed: SECONDARY SCHOOL STUDIES (A Levels) Please attach additional sheets if more space is required. Qualification: YYYY To: DD MM YYYY Institution: Grade Attained: Year enrolled: 3. PARENT/GUARDIAN DETAILS Guardian Title (e.g Mr/Mrs/Miss/Ms): First Name: Occupation Permanent Home Address. If yes, please indicate the date your results will be available: SECONDARY SCHOOL STUDIES (O Levels) Address for Correspondence: (If temporary please specify dates) Parent No Other .......................................... 2. STUDENT DETAILS Title (e.g Mr/Mrs/Miss/Ms): First Name: Last Name: Date of Birth: DD MM YYYY Country of Birth: Gender (M/F): Marital Status: Nationality: (Please attach birth certificate) Country of Ordinary Residence: Permanent Home Address. MM Are you currently studying? Yes What is the name of your school? Art & design, Interactive media, Graphic Design. Computer Game design, Computer game animation. From: DD Tel No: (inc. dialing code) Email Address: 4. EDUCATION CURRENT STUDIES Next of Kin POST SECONDARY STUDIES (Diplomas/Degrees) Please attach additional sheets if more space is required. Last Name: Qualification: Institution: Grade Attained: Tel No: (inc. dialing code) Email Address: Address: 245 Tank Hill Road Muyenga Year completed: Year enrolled: Email: [email protected] Year completed: Website: www.axial.co.ug 5. EMPLOYMENT Are you currently employed? Yes No If yes, what is the name of your employer? Is your employment Full time Part time 6. GENERAL Do you have any applications to other institutions of higher education currently under consideration? Your answer will not prejudice you application. Please specify: …............................................................................................................................ .................................................................................................................... Do you have a disability(s) we should be aware of? Yes No If yes, details: ................................................................................................................................ .................................................................................................................... Do you have a criminal record? Yes No If yes, details: ................................................................................................................................ .................................................................................................................... How did you hear about Axial International College? …................................................................................................ .................................................................................................... .................................................................................................... ................................................................................ Did you use our website to find out information about the College before applying? Yes No If yes – did you find all of the information that you needed? Yes No If no then please tell us what you would like to have found. …................................................................................................ .......................................................................................... 7. KNOWLEDGE OF LANGUAGE English Language Classes (including classes at school) Total years of study in English within your own country: Year(s) Years of study in English abroad. Name of institution(s) where you studied in English: Country: From: Year(s) To: Years of study in English at higher education: From: Year(s) To: LEVEL OF ABILITY Language Excellent Very Good Good Fair English Mother tongue DECLARATION I understand that: • Axial reserves the right to discontinue or alter any program, course/subject, fee, admission, requirement, staffing or other arrangement without prior notice subject to the refund policy. • I may access my own student records, subject to privacy legislation. For more detailed information on Axial’s privacy policy please contact Axial International College. • Tuition fees are to be paid as per the payment schedule that will be included in the offer letter if my application is successful, and tuition fees will increase if I need to repeat courses, assessment or undertake additional electives that will exceed the minimum requirement. • My application fee will only be refunded if my application is not successful. • If an offer of a place is made, it will be conditional upon a face-to-face meeting or a phone call at the request of the Axial advisory team. • If under 18 years of age then a guardian will be required to sign for you and to present a copy of their identification (passport or National ID). I declare that to the best of my knowledge the information supplied in this application and the documentation supporting my application is correct and complete and that any portfolio, personal statement or additional documents are my own. I acknowledge that the withholding of information or provision of incorrect documentation relating to my application may result in cancellation of any offer of enrolment by Axial. Have you completed all sections of the application form and read and understood the declaration? Yes No If you choose to print this form instead of e-mailing it, then the student or guardian must sign (must be 18 years or older to sign) Signature: Date: ___________________________________ PERSONAL STATEMENT “Why I want to study my chosen programme and why I want to study at Axial International College.’’ (To be submitted by all applicants. Please attach a typed answer to the above question with no more than 500 words.) Address: 245 Tank Hill Road Muyenga Email: [email protected] Website: www.axial.co.ug