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Enrolment Form
PRINTMAKING COURSES with The Centre for Lifelong Learning
Autumn Term 2008
To enrol on any of these courses, please fill in and return
this form with payment to:
The Centre for Lifelong Learning, 2nd Floor Bedson Building,
King;s Road, Newcastle University Campus, Newcastle upon Tyne NE1 7RU.
THE
CLL OFFICE
HAS
MOVED. PLEASE NOTE THE NEW ADDRESS.
To pay by credit
card or enquire about places and enrolments
phone 0191 515 2800 or
0191 515 2890. Cheques should be made payable to
the
University
of Sunderland.
PRE-ENROLMENT IS ESSENTIAL IF YOU WISH TO RESERVE A PLACE ON A COURSE.
For
enquiries about course information phone Carol on 07989 955108 or Rebecca
on 07717 256169 or email
info@horsleyprintmakers.co.uk.
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Courses at Horsley Printmakers in the Hearth @ Horsley |
Fee |
Course no |
Please tick |
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RELIEF PRINTMAKING
(incorretly titled as Alternative Lino-Cuts for Textiles)
Mandy Pattullo
Tuesdays | Sept 30 2008 | 8
meetings | 18:45 - 21:15 | The Hearth at Horsley |
£94.00 full
£79.00 retired
£55.00 students/benefits |
20081621 |
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TEXTURED PRINTS ON PAPER AND FABRIC
Carol Nunan
Fridays | 7, 14, 21, 28 Nov 2008 | 4 meetings | 10:00 - 16:00 |
The Hearth at Horsley |
£94.00 full
£79.00 retired
£55.00 students/benefits |
20081626 |
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SKETCHING AND PAINTING WITH MONOTYPE
Carol Nunan
Fridays | 3, 10, 17, 24 Oct 2008 | 4 meetings | 10:00 - 16:00 |
The Hearth at Horsley |
£94.00 full
£79.00 retired
£55.00 students/benefits |
20081625 |
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IMPRESSIONS IN TEXTURE COLLAGRAPH WORKSHOP
Rebecca Vincent & Carol Nunan
Saturday & Sunday | Oct 4th & 5th 2008 | 2
meetings | 10:00 - 16:00 | The Hearth at Horsley |
£47.00 full
£39.50 retired
£27.50 students/benefits |
20081624 |
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MONOTYPE EXPERIMENTING WITH COLOUR
Rebecca Vincent & Carol Nunan
Saturday & Sunday |
Nov 29th and 30th
2008 | 2 meetings | 10:00 - 16:00 | The Hearth at Horsley
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£47.00 full
£39.50 retired
£27.50 students/benefits |
20081627 |
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ETCHING THE BEAUTY OF LINE AND TONE
Rebecca Vincent & Carol Nunan
Saturday & Sunday |
Oct 18th and 19th
2008 | 2 meetings | 10:00 - 16:00 | The Hearth at Horsley |
£47.00 full
£39.50 retired
£27.50 students/benefits |
20081628 |
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CHRISTMAS CUTS
Mandy Pattullo
Saturdays |
Nov 15th and 22nd
2008 | 2 meetings | 10:00 - 16:00 | The Hearth at Horsley |
£47.00 full
£39.50 retired
£27.50 students/benefits |
20081623 |
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TEXTURES FOR TEXTILES
Mandy Pattullo
Tuesday - Friday | 28 31 Oct 2008 | 4 meetings | 10:00 - 16:00 |
The Hearth at Horsley |
£94.00 full
£79.00 retired
£55.00 students/benefits |
20081622 |
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Title: |
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First Name: |
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Surname: |
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Date of
Birth: |
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19 |
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Gender: |
Female |
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Male |
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Address: |
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Postcode: |
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Country of
normal residence: |
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Telephone
(Day): |
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Telephone
(Evening): |
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Telephone
(Mobile): |
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Email
Address: |
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May we send
you news and updates about CLL via email? |
Yes |
No |
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How did you
find out about this course? |
Brochure |
Friend |
Web |
Other |
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Have you
previously attended a course at the Centre for Lifelong Learning? |
Yes |
No |
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If you have
answered No to the above, please provide the following information
which we are required to collect for Government statistical
purposes. The Notes overleaf will help you to complete this
section |
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Do you
consider yourself to be disabled? |
Yes |
No |
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If yes,
please see Note 1 and enter the code which best describes your
disability. |
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Do you
require any specific support, because of your disability, to
enable you to participate in this course? |
Yes |
No |
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Do you give
permission for us to disclose information about your disability to
relevant University Staff? |
Yes |
No |
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Nationality: |
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Ethnic
Group: (Please see Note 2 and enter the appropriate code) |
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What is your
highest qualification?: (Please see Note 3 and enter the
appropriate code) |
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The details
on this form are correct to the best of my knowledge. I sign to
show that I accept the terms and conditions printed on my
certificate of enrolment. I acknowledge that fees are due upon
enrolment. |
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Signature of Student
Date
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Note 1: If you have a disability,
please use one of the following codes. If you have more than one
disability please use Code 8.
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0 |
NO
KNOWN DISABILITY |
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1 |
DYSLEXIA |
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2 |
BLIND/PARTIALLY
SIGHTED |
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3 |
DEAF/HEARING
IMPAIRMENT |
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4 |
WHEELCHAIR
USER/MOBILITY DIFFICULTY |
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5 |
PERSONAL
CARE SUPPORT |
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6 |
MENTAL
HEALTH DIFFICULTY |
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7 |
UNSEEN
DISABILITY - e.g. DIABETES, EPILEPSY, ASTHMA |
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8 |
MULTIPLE
DISABILITIES |
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9 |
OTHER
DISABILITY |
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T |
AUTISTIC
SPECTRUM DISORDER/ASPERGER SYNDROME |
Note 2: Please write one of the
following codes overleaf against Ethnic Group.
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11 |
WHITE - BRITISH |
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12 |
WHITE - IRISH |
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13 |
WHITE - SCOTTISH |
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14 |
IRISH TRAVELLER |
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19 |
WHITE - OTHER |
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21 |
BLACK - CARIBBEAN |
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22 |
BLACK - AFRICAN |
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29 |
BLACK - OTHER |
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31 |
INDIAN |
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32 |
PAKISTANI |
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33 |
BANGLADESHI |
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34 |
CHINESE |
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39 |
ASIAN - OTHER |
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41 |
WHITE/BLACK CARIBBEAN |
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42 |
WHITE/BLACK AFRICAN |
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49 |
OTHER MIXED RACE |
Note 3: Please write one of the
following codes against Highest Qualification. If you have more than one
of the qualifications listed below, choose the qualification with the
lowest code number.
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01 |
HIGHER DEGREE-MASTERS OR
ABOVE |
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02 |
POSTGRADUATE DIPLOMA |
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03 |
PGCE WITH QTS |
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04 |
PGCE WITHOUT QTS |
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05 |
POSTGRADUATE UNSPECIFIED |
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10 |
1ST DEGREE QTS |
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11 |
FIRST DEGREE OF UK INSTITUTE |
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12 |
GRADUATE OF EU INSTITUTION |
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13 |
GRADUATE OF OTHER OVERSEAS
INS |
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14 |
GNVQ/GSVQ LEVEL 5 |
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15 |
NVQ/SVQ LEVEL 5 |
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16 |
OTHER DEGREE GRADUATE EQUIV |
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21 |
OPEN UNIVERSITY CREDITS |
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22 |
OTHER UK HE CREDITS |
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23 |
CERT/DIP IN EDUC-TEACHERS
ITT |
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24 |
HNC OR HND (BTEC/SCOTVEC) |
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25 |
DIPHE |
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27 |
NVQ/SVQ LEVEL 4 |
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28 |
PROFESSIONAL QUALIFICATIONS |
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29 |
FOUNDATION HE COURSE |
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30 |
OTHER HE BELOW DEGREE LEVEL |
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31 |
FOUNDATION DEGREE |
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39 |
A LEVEL EQUIVALENT OTHER |
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40 |
A/AS LEVELS |
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41 |
ONC OR OND (INC BTEC &
SCOTVEC |
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43 |
FOUNDATION FE COURSE |
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44 |
ACCESS COURSE RECOGNISED |
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47 |
BACCALAUREATE |
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48 |
ACCESS COURSE |
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55 |
GCSE / O LEVEL/ SCE O |
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92 |
APEL ACCRED PRIOR EXPERIENCE |
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93 |
NON FORMAL APEL/UNIV
ENTRANCE |
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97 |
OTHER NON UK LEVEL UNKNOWN |
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98 |
NO FORMAL QUALIFICATIONS |
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