Middle names


Date of Birth

Age on 1st September 2017


Date of entry to UK

Passport Number

Passport Expiry

Street Address


Post Code


Personal Email Address

Telephone Number

Mobile Number

Name and Address of Sponsor, Parent or Guardian (if applicable)

Sponsor Email Address

Sponsor Telephone Number

Main Programme/Course you are applying for (eg A-levels, Diploma in...)

Previous Qualifications (please state the name of the institute, qualification level, year taken and whether the grade is predicted or achieved).

Results of any English Language examinations (eg IELTS, Pearson, Cambridge)
If you are yet to take English Language qualifications write approximate test date below

Details of work experience (paid or voluntary). Include any work done through School/College
Job Title
Date From
Date To

Did you have additional support, such as LSA or extra time in school/exams? YESNO

Do you have a medical condition that may impact on your studies, for example Epilepsy? YesNo
If YES, please specify

Do you regard yourself as having a disability or learning difficulty? YesNo
If YES, please specify

Do you have any criminal convictions or charges pending? YESNO

Personal Statement - Please explain why you have chosen your course of study at Pembrokeshire College.

How did you hear about Pembrokeshire College? AgentFriendBritish CouncilAdvertisementCollege WebsiteHot Courses WebsiteOther

Name and contact details of the agent who is helping you with you application

I have completed this form myself and I have read and understood the CONDITIONS OF ADMISSION as detailed. I also confirm that the information in this form is true, complete and accurate: no information requested or other material information has been omitted.

Tuition Fee Payment

Please note that the tuition fee does not include charges for books, accommodation, activities, living costs and transport.

The tuition fee must be paid in full at least 6 weeks before the course starts.

Refund Policy

Before Arrival

  • In case of refusal of entry to the UK by the Immigration or Visa Authority, a refund will be granted less a £100 administration fee.
  • There is no reduction in fees in the case of a late arrival or early departure from a course.

After Arrival

A refund will NOT be considered if any of the following have occurred:

  • The student has broken the law or conditions of his/her visa and is thus required to leave the country as a consequence.
  • The student’s visa is revoked as a consequence of not attending the course regularly.
  • The student has broken the Terms and Conditions of admission to the college.
  • The student wishes to leave the course, without good reason.

All applications for a refund must be made in writing, giving full details of why a refund is being asked for, and should be accompanied by any relevant documentary evidence.

Where a student has paid through an educational advisor or agency, if a refund is granted it will be made to the advisor or agent from whom the student should seek a refund. Where a student has paid to the college directly a refund will be made directly to the student.

Please note that it takes at least 3 weeks to process a request for a refund.

Can you defer your course?

If you are not entitled to a refund, you may wish to return to the college at the start of next academic year to continue studying. This is only possible upon the provision of at least one week’s notice. Pembrokeshire College will notify the Home Office immediately of any course deferrals.

Data Protection Act

By completing this form, I agree for my personal details to be stored on a secure College database, which can be inspected by request to the Computer Services Help Desk.

Important information

The College makes all reasonable efforts to ensure that the contents of the Students Guide (prospectus) are accurate and to deliver the programmes of study and research opportunities and other services and facilities in the way described in the Guide. The College will provide students with the tuition and learning support and other services and facilities it describes with reasonable skill and care. However, the College shall be entitled, if it reasonably considers it to be necessary, (including in order to manage its resources and pursue its policy of continuous improvement appropriately):

  • to alter the timetable, location, number of classes and method of delivery of programmes of study, provided such alterations are reasonable;
  • to make reasonable variations to the content and syllabus of programmes of study (including in relation to placements);
  • to suspend or discontinue programmes of study;
  • to make changes to its regulations, policies and procedures which the College reasonably considers necessary;
  • not to provide programmes of study or to combine them with others if the College reasonably considers this to be necessary (for example, because too few students apply to join the programme for it to be viable).

In the unlikely event that the College discontinues or does not provide a programme of study or changes it significantly before it begins:

  • the College will inform relevant individuals as soon as is reasonably practicable;
  • an individual will be entitled to withdraw his/her application within 14 days of being informed of the change;
  • for those individuals that are either enrolled on a course which is discontinued or withdraw their applications under the paragraph above, the College will make an appropriate refund of tuition fees and deposit paid.

Upon acceptance by an applicant of an offer of a place at the College, the relationship between the applicant and the College becomes contractual. In entering that contract neither the student nor the College intends that any of the terms of the contract will be enforceable by virtue of the Contracts (Right of Third Parties) Act 1999 by any person not a party to it. Further detail can be obtained from the College website:

The College will not be liable to you for any representations or descriptions in this form, or in any other College documents and publications including website, and/or to you verbally, unless and to the extent confirmed in the terms as outlined above.

The College excludes any liability which it would be unlawful to exclude.

The College will not be liable to you in any manner whatsoever for any failure or delay or for the consequences of any failure or delay in performance of any contract with you if it is due to any event beyond our reasonable control including, without limitation, strikes, lockouts or other industrial action or disputes (whether involving our workforce or any other party), acts of God, pandemic, quarantine or widespread illness (whether affecting our staff/or student body otherwise), governmental requisitioning, emergency planning or provision, war, protest, fire, flood, storm, tempest, explosion and suspected or a threatened act of terrorism, riot, civil commotion, national emergencies, breakdown of plant or machinery or default of suppliers or sub contractors.

The College has a disciplinary procedure policy which is available in the student handbook and on the Intranet. The College reserves the right to withdraw any offer of a place if information becomes available which has not been declared in this application form.

Advice and Additional Information for Potential Students:

  1. Please read carefully the terms and conditions of admission.
  2. Do not enter the UK on a visitor’s visa. Obtain permission to enter as a student.
  3. It should not be necessary for you to enter the UK until one week before your course begins. Bear in mind that UK Visa Control will expect you to bring all documents relevant to your studies (offer letters, original certificates of your qualifications, receipts for fees paid and if possible a letter or recommendation from your bank).
  4. Many immigration problems can be avoided by production of a letter from the College showing that payment of tuition fees has been made.
  5. Pembrokeshire College reserves the right to amend, where necessary, fees and dates of courses.
  6. If you require any further information please contact Pembrokeshire College International Office at