
ENROLMENT APPLICATION FORM
2011/12
Full name…………………………………………….. (Mr/Mrs/Ms/Miss/Dr./other…....…..)
Address……………………………………………………………………………………………………….
……………………………………………………………………………………………………………
Post Code………………………………...
Telephone (please include dialling code)…………………………………………. DOB………………….
Academic/Professional qualifications ………………………………………………………………………….
Please enrol me on the following course(s)…………………………………………………………………...
Payment of fees: Please complete and tick the boxes as appropriate
□ I enclose the full course fee(s) of £
□ I enclose a deposit of £ and a completed bank standing order mandate.
□ I wish to pay by Credit/Debit card
Due to the increasingly high charges levied by the card companies, we regret that
we must add 4% to all credit card transactions.
This does not, however,
apply to debit card s.
Please provide the following information:
Card Type: Credit Card □ Debit
Card □ Visa □ Mastercard □ American Express □
Card number: □□□□□□□□□□□□□□□□
Card security number (last 3 digits) □□□
Card Expiry Date: Month □□ Year □□□□ Issue No □□ (Switch only)
Please note that:
(1) The name and address on the card must be identical
to that given above
(2) We cannot process your payment without the last
three digits of your card security code ~ this number is
printed next to your signature on the reverse of the card.
Please make all cheques payable to:-
The Small Print -
I confirm that I have read and understand the terms and conditions printed here and
in my prospectus. I confirm that I agree that the sight and use of all and any
course material supplied to me will be restricted solely to my own personal use and
that under no circumstances whatsoever will any such material, or part thereof, be
shown, given, lent, sold or otherwise conveyed, in any form whatsoever, to any third
party. I have taken particularly careful note of, and confirm my unconditional agreement,
with regard to the copyright clause(s) set out in the prospectus and all course materials.
I will complete the end of module/study book assignments (not RHS1) and send them
to my tutor for marking as required by the course content. These assignments will
be marked and returned to me as soon as possible but the Institute can take no responsibility
for late or non-
When my courses
fees have been paid in full I will be entitled to receive materials and tutorial
support relevant to my course for a period of two years (unless stated otherwise
in the course description e.g. RHS1) from the date of my registration,
It is
important that prospective students understand the position with regard to fees paid.
We do not sell written course texts or other materials. We provide integrated courses
of study that comprise tutorial provision, written and other materials relevant to
each course and student. It is a course of study, essentially a service, not a set
of written texts, that the payment of fees provide and fees are applied whether or
not the service is used.
It is my sole responsibility to check and ensure my eligibility
for any external examinations also registration and the arrangements for, and the
sitting of, any such examinations. Fees for such external examinations are not included
in my course fee.
Provided that I complete the course in a satisfactory manner and attain the appropriate
standard, I will be awarded the certificate or diploma relevant to that course and
will be entitled to use the qualification title or designation (if any) associated
with it. I further understand that all course fees are non-
This Agreement and conditions and each and every agreement made
pursuant thereto shall be governed in all respects by and construed in accordance
with the law of England and shall be subject solely to the jurisdiction of the Courts
of England. Signing this agreement signifies my unconditional and irrevocable agreement
with this and the other clauses above.
Signed Date
Please return this form, together with your remittance, to:
The Institute for Horticultural & Rural Studies
Pethick Park
Bucklawren Road
LOOE
PL13
1QR
United Kingdom
It would be very helpful if students would kindly outline their horticultural, agricultural or other relevant experience (if any) to date together with an indication of their aims and objectives in taking the course(s) chosen. We also need to be aware of any particular circumstances, requirements or special needs that will (or could) affect your study. This will enable the Director of Studies to place students in the care of the tutor most appropriate to their needs. All such information will, of course, be treated in the strictest confidence. Please provide these details on a separate sheet.