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Pre Evaluation Form
Section A: Personal Details
Full Name : * Title :
Gender : Male Female
Date of birth : *
Marital Status : Single Married Divorced Widow
Nationality : *
   
Section B: Personal Details
Address : *
City : *
Post Code :
Tel No : *
Fax No :
E-Mail :
   
Section C: Course/Country Choice
Country you wish to study : *
University you are applying for : *
Degree Qualification applied for : *
Department in which you want to study : *
Intake :
Have you taken an English Proficiency test in last 2 years : IELTS TOEFL OTHER
IELTS Score * TOEFL Score *
Other Information
   
Section D: Funding
Who will support you financially for your studies :
Available bank statement : *
Fatherís source of income : *
   
Section E: Sponsor Information
Name of your sponsor :
Profession : Occupation :
Where is your sponsor living : His/Her monthly income :
   
Section F: Previous Education
1. Dates: To : * From (mm/yy) : * Degree : *
Institution : *
Subject : *
Class/Grade : * Course duration (mm/yy) : * Date of award (mm/yy) : *
   
2. Dates: To : From (mm/yy) : Degree :
Institution :
Subject :
Class/Grade : Course duration (mm/yy) : Date of award (mm/yy) :
   
3. Dates: To : From (mm/yy) : Degree :
Institution :
Subject :
Class/Grade : Course duration (mm/yy) : Date of award (mm/yy) :
   
Section G: Previous Employment
Please provide detail of any employment undertaken within the last three years.
From To Name and address of employer Position held
   
Section H: Referees
Please supply the name and addresses of two referees from whom a reference may be sought
Name : * Name : *
Title : Title :
Address Line 1 : * Address Line 1 : *
Address Line 2 : Address Line 2 :
Post Code : Post Code :
Tel No : * Tel No : *
Fax No : Fax No :
E-mail : E-mail :
Time known : Time known :
   
Section I: Marketing Information
It would be helpful if you could indicate where you heard about HR Consultants
Advertisement Friend/Relative Promotional Material Tutor/lecturer
   

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