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Application Form - Expressions of Interest in Future Courses

Instructions

Applications for the April 2010 Course modules have now closed.

Please use this form to tell us if you might be interested in enrolling for the September 2010 course for one (or two maximum) of these modules. You can see more detail about the course modules offered at http://www.peoples-uni.org/book/courses-offered.

You will not be committed to doing the courses selected, you can change your mind later. The information is being requested to help us plan the courses, and to allow us to notify you when enrolments are open. We are planning to add other modules, please also let us know if subjects not currently on the list would be of special interest to you.

We will then send you further information when applications open.

 

Your family name

Your first or given name(s).

Please select the first course module you may be interested in applying for from the drop down box.

If you may be interested in applying for two course modules, please select the second course module are interested in from the drop down box.

Enter the the details of public health related courses that you would like us to offer.

Your country of residence. Select from list.

Please enter the email address by which you wish to be contacted by when enrollment can be completed.

Please reenter your email address to verify that is correct

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