Apply – Nami Site

INTERNATIONAL APPLICATION FORM * indicates a required field COURSE DETAILS

Proposed Course/s

Please attach your photo (Max image size not exceeding 500Kb. Supported format are jpg, png.)

PERSONAL DETAILS Please complete in CAPITAL letters

Title (Mr, Miss, Mrs, Ms) *

Surname (Family Name) *

First (Given Name/s) *

DOB *

Nationality *

Home Address *

E-mail Address *

QUALIFICATION ACHIEVED

Name and address of place of study

Date attended (From and To)

Title of qualification, grade obtained and awarding body

Date obtained

QUALIFICATION PENDING / AWAITED

Name and address of place of study

Date attended (From and To)

Title of qualification, grade obtained and awarding body

Date obtained

ENGLISH LANGUAGE If English is not your first language, please provide us with details of your English Language qualifications i.e IELTS or TOEFL. If you have alternative evidence, e.g. have been taught English, please give details below

EMPLOYMENT HISTORY

Date attended (From and To)

Employers Name & Address

Position Held

Brief Description of Duties

PERSONAL STATEMENT

Please include any information, which would assist us in considering your application. For example, reason for choosing course/subject, career aspirations etc. MBA applicants should provide, in addition, full details of employment experience and managerial responsibilities (experience of managing money, people and other resources).

REFERENCE Please attach one written reference to this form. A referee must be able to comment on your academic ability and must not be related to you. You should provide full contact details for the referee. The referee should provide the reference in a sealed envelope and should sign across the seal.

Name

Address

Tel Number

Fax Number

E-mail Address

Name and address of Person / Organisation who is paying your fees:

Telephone Number:

E-mail Address:

Please attach written reference (Max size not exceeding 1mb. Supported format are png, jpg, pdf.)

CRIMINAL CONVICTIONS If you have a criminal conviction please complete section 1 OR 2.

Section 1: Courses in teaching, health, social work with children or vulnerable adults: I have a criminal conviction.I have a spent criminal conviction.I have a caution (including a verbal caution).I have a bind-over order.I am serving a prison sentence.

Section 2: All other courses: I have a relevant criminal conviction that is not spentI am serving a prison sentence for a relevant criminal conviction. Relevant Criminal convictions are only convictions for offences against the person, whether of a violent or sexual nature, and convictions for offences involving unlawfully supplying controlled drugs or substances where the conviction concerns commercial drug dealing or trafficking.

**Convictions that are spent (as defined by the Rehabilitation as per Nepal law) are not considered relevant and should not be revealed.

DECLARATION Information on this form is subject to the Data Protection Act 1998, and may be sent to the Department of Education. Exemptions to the Act require that, in certain circumstances including the prevention and detection of crime, details must be provided to the Police or other relevant authorities.

I declare that the information on this form is correct to the best of my knowledge. I understand that if I have been found to have deliberately and seriously misled the College about the details on this form I could be asked to withdraw from my course.

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