Application Form - Le Cordon Bleu

Emergency ContactName_________________________________________________________ Relationship __________________________Address ____________________________________________________________________________________________Phone no. _______________________________________ Mobile no. __________________________________________Financial SponsorName________________________________________________________ Relationship ____________________________Address ____________________________________________________________________________________________Phone no. __________________________________________ Mobile no. _______________________________________CourseTerm January April July October Year ____________ Tuition Fee __________________Classic Cycle – Cuisine Level Basic Intermediate SuperiorClassic Cycle – Patisserie Level Basic Intermediate SuperiorCertificate IV in Menu Planning and Cost ControlDiploma of Professional Culinary ManagementEnglish Language for Hospitality and Tourism Courses Level Basic Intermediate AdvancedMotivationPlease give a statement of your motivation to study this program (can write in Eng or Thai)._______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________How did you hear about this program? _________________________________________________________________I acknowledge that all the information provided on this form is correct and declare that I will abide by the terms and conditionsin the Fees, Conditions, and Refunds Policy. I agree to be bound by Le Cordon Bleu Dusit rules and regulations, andacknowledge that all disputes arising from the details and conditions contained in the application shall be governed by andconstructed in accordance with the laws of the Kingdom of Thailand and be submitted to the jurisdiction of the courts ofThailand.I understand that the information provided by me to the School may be made available to MOE as well as ImmigrationAuthorities and on the Le Cordon Bleu world wide ONYX database for alumni purposes.I declare that I have read and understood each of the School’s Codes of Practice, Policies and Procedures and AccreditationStatus.Name of Student: ________________________________ Signature ____________________________ Date ____________Name of Guardian: ______________________________ Signature ____________________________ Date ____________Name of Financial Sponsor: ________________________ Signature ____________________________Date ____________Le Cordon Bleu Dusit Culinary School946 The Dusit Thani Building, 1 st Floor, Rama IV Road, Silom, Bangrak, Bangkok 10500 THAILANDTel: +66 (0) 2237 8877 Fax: +66 (0) 2237 8878Email: thailand@cordonbleu.edu