International Communications Council
Application Form
Course
※
Course
※
Course Code
※
Affiliated institution
※
Name
Sur name
Given name
※
Date pf Birth
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
/
1
2
3
4
5
6
7
8
9
10
11
12
/
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
※
Address
※
Mobile phone number
※
Mail address
※
Guarantor
Name
Relationship
Address
Mobile Phone number
※Emergency phone number
Passport ・ Visa (No information is reguired for Online Course applicants)
Passport
I have a valid passport
I don't have a valid passport
Name
Passport Number
Nationality
Issuing country
Date of issue
Date of expiry
VISA
Do you need a student visa to enter UK?
A student visa is not required.
A student visa is required.
Mark below your English proficiency.
※
Proficiency
level
IELTS
TOEFL iBT
TOEFL CBT
TOEIC
EIKEN
1
9
120
297－300
-
-
2
8.5
119
293
-
-
3
8
117－118
287－290
-
-
4
7.5
109－116
267－283
970－990
-
5
7
100－108
250－263
870－970
1
6
6.5
90－99
233－247
820－870
-
7
6
80－89
213－230
740－820
Pre-1
8
5.5
69－79
192－212
600－740
-
9
5
61－68
173－190
550－600
2
10
4.5
52－60
150－170
500－550
-
11
4
45－51
130－149
450－490
Pre-2
12
3.5
33－44
110－129
300－440
-
13
3
29－32
100
291－299
3
14
2.5
20－28
90
270－290
-
15
2
12－19
-
260－269
4
16
1.5
-
-
100－259
5
