Application Form

Form

To be completed by institutions applying to become Learning Centre for English

Web :-www.ukawards.org.uk

Email:-Info@ukawards.org.uk

please ensure that all relevant parts of sections A to B are completed.

Section A :Centre details

Full name of centre (as you would wish it to appear on certificates): *

Name of Head / Principal: *

Full Postal Address: *

Postal Code: *

Country: *

Phone number: *

Please include your country code

Fax Number: *

Please include your country code

Email address: *

Website address: *

If applicable

Address for courier delivery of parcels: *

Note :- PO boxes cannot be accepted

Does the Centre have any sub-sites?

If any of these sub-sites are to be used for leaning purpose, please provide the address details of each of the sub-site: *

Telephone Number (include country code):

Fax Number (include country code):

Email address (of Examinations of sub-site): *

Centre website address:

Section B:- Please provide the information on the following resources for delivering English Language at your Centre:

Selected Value: 0

How many teachers do you have?

How many classroom do you have?

What is the seating capacity of each classroom?

Please confirm whether the classrooms have:

Please provide details of the following:

1.Projection equipments (e.g. Projector model number, display screen etc.):

2.Video conferencing facility (if available):

Signed:

Date:

Name of Head / Principal:

For and on behalf of (name of establishment):