Canbourne University
Pre-Assessment Evaluation Application Form

How does the process work?

Prospective students submit this Pre-assessment Application Form for the degree of their choice – BS; BA; MA; MS; MBA; or PhD. Our Educational Assessment Committee will review and evaluate the application. If you can qualify, one of our registrars will contact you by e-mail or by telephone with the results of the evaluation.

Please complete this evaluation form as thoroughly as you can so that we can accurately
assess your accomplishments.

Incomplete forms will not be processed.

This assessment is totally free of any charge, and does not obligate you in any manner.

This form was originally created for on line use. You may however print it out on your computer,
and once it is complete you may fax it to us at 44-207-900-6917

About You

Full Name:*

___________________________

Date of Birth:*

___________________________

Gender:*

Male / Female

Years of Experience
(related to your field):*

_____

Current Position at Work
(e.g. Manager, Secretary, etc.):*

__________________________________________________

Years in Current Position:

_____

Estimate Your Annual Income:*

$ US _____________

Estimate Income with New Degree:

$ US _____________

Highest Level of Formal Education Completed:*

Elementary School / High School / Associate Degree/
Bachelor Degree / Master Degree / Doctorate

 

Certificates or Other Training Completed:

__________________________________________________
__________________________________________________
__________________________________________________

Your Degree Preferences

Degree Preference:*

High School (from associated institute)
Associate (AA /AS)
Bachelor (BA / BSc / LLB)
Masters (MA / MSc / MBA)
Doctorate (PhD / PsyD / EdD / DdD / JD etc.)
Other or Additional (please specify below):

Preferred Field of Study:

__________________________________

Other (please enter other field of study):

__________________________________

Briefly Outline the Work / Life Experience
That May Qualify You for This Degree:
Note: there is no need to falsely your claims. We may call
you to review your relevant experience. We rely on you
to submit truthful information regarding your experience.

__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________

Please Describe Any Other Information You Feel
 May Help You Qualify for the Degree You Seek.
(include military experience, volunteer work, etc.):

__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________

Resume / CV:
(If you have a resume, please paste it on the right)

->

Your Contact Information

International Telephone Code:*

______

City Telephone Code:*

______

Primary Telephone Number:*

__________________

Secondary Telephone Number:

__________________

Mobile Telephone Number: 

__________________

Fax Number: 

__________________

Contact E Mail Address:*

____________________________________

Retype Contact E Mail Address:*

____________________________________

Address:*

__________________
__________________
__________________

City:*

___________

County / State / Province / Region / District:

___________

Post Code*

___________

Country*

___________
General

How did you hear about this site?

__________________________________________________
Agreement Section

By pressing the send button, you are aware of and agree to the following:

• I certify that I am over 18 years old, and the person who's name appears on this application, and that all the information I have provided is complete and accurate to the best of my knowledge.

• I understand that this is a pre-assessment application form that will be forwarded to Canbourne University, if this application meets their standard. I hereby give them the right to call my telephone numbers, as submitted, for any further inquiries.

• I understand that withholding information requested, or giving false information, may make me ineligible for admission and enrolment. I understand that if I fabricated any issues herein, I am eligible for prosecution and/or revocation of any degree that may be awarded.

• I authorize the Online University Degree program to utilize any and all public means available to verify the information herein. I UNDERSTAND CANBOURNE UNIVERSITY WILL NOT CONTACT MY EMPLOYER OR ANY PREVIOUS EMPLOYER WITHOUT MY DIRECT CONSENT.

• I understand Canbourne University admits students of any race, religion, age, sex, colour handicap, sexual orientation and national or ethnic origin to all the rights and privileges, programs, and activities generally accorded or made available to students at the university. it does not discriminate on the basis of race, religion, age, sex, colour handicap, sexual orientation and national or ethnic origin in administrating it's educational policies, admissions policies, or other university administered programs.

(Type your name here)__________________________

Signature:________________________

Within 5-6 business days of sending this application, you should receive an acknowledgement form the registrar's office.

 

 

 

This form was originally created for on line use. You may however print it out on your computer,
and once it is complete you may fax it to us at 44-207-900-6917

 

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