Graduate Registration form

Please complete all fields marked with a *

Your personal details
Title	Mr Mrs Ms Miss Dr Prof
First name*
Last name*
Home Address
Address1*
Address2
Town
County
Postcode/Zip*
Home Telephone
Local/Term Address
Address1*
Address2
Town
County
Postcode/Zip*
Telephone
Mobile Telephone
Email address*
Degree Course
Graduation Date	dd/mm/yy
University
Class of Degree
Where did you hear about us

Under the terms of the Data Protection Act 1998, the personal information you supply will be treated in confidence, but will be used internally for registered purposes. Some information on this form will be sent to the Learning & Skills Council and the Department for Education & Skills for statistical purposes. Cornwall College is committed to keeping you informed of new courses and/or qualifications. If you would like to receive this information, please tick here.