Professional Documents
Culture Documents
1. Centre Details
Centre:
Online
Submission Period:
Start Date:
2. Student Information
Title: Family Name or Surname: First Name(s): Gender: Date of birth (dd/mm/yy): ACCA Registration Number: Have you 'opted in' to the ACCA/OBU scheme? Yes No Male Female County: Country: Telephone: Mobile: Email address: Have you already completed the online ethics module? Yes No Postcode: Address:
3. Payment Details
Please select the postage location for the learning materials: Amount Payable:
United Kingdom and Northern Ireland European Union, CI and BFPO Rest of the World
Book Delivery Address: (If different from above)
Course Fee Postage Cost (UK Free / EU 10 / Rest of the World 40) Total Amount Payable
485
PAYMENT METHOD: Please select a payment method which is convenient to you. I enclose a cheque/draft for _________ made payable to Kaplan Open Learning I wish to pay __________ by Credit/Debit card. Please call 0113 388 8499 to make payment (UK cards only) Please invoice my Employer. (Full payment must be received by us before the course start date) Company Name: Manager's Name: Manager's Email: I wish to pay by Bank/Electronic Transfer Telephone: Address:
Please transfer the amount payable to the following Bank Account quoting a reference: OB - [Your Full Name] Bank Name: Natwest Bank Account Name: Kaplan Open Learning (Essex) Limited Account Number: 20674848 BIC: NWBK GB 2L IBAN: GB71 NWBK 5000 0020 6748 48
Where did you hear about the Oxford Brookes online mentoring course? Kaplan Centre/Tutor Oxford Brookes University Have you studied with Kaplan before? Email from Kaplan Other Yes No Kaplan Website Internet Search Word of Mouth
Sort-Code: 50-00-00
Printed Leaflet
Registered Company Name: Kaplan Open Learning (Essex) Limited Company Registration Number: 06245017 - Registered Office: 100 Cannon Street, London EC4N 6EU
4. Declaration
By submitting this form, I confirm that I have read, understood and accept the terms and conditions below: Date:
Please return the completed form and a scanned copy of your photo ID to: oxfordbrookesonline@kaplan.co.uk Please send your cheques/drafts to: Kaplan Open Learning, West One, 114 Wellington Street, Leeds LS1 1BA If you require further information, please call 0113 388 8499
Registered Company Name: Kaplan Open Learning (Essex) Limited Company Registration Number: 06245017 - Registered Office: 100 Cannon Street, London EC4N 6EU