Leo Baeck College 80 East End Road, , N3 2SY Tel: +44 020 8349 5600 Email: [email protected]

Applications for the College courses must be received by 30th June for admission in the ensuing academic year.

Please note checklist of additional information required at the end of this form.

STRICTLY CONFIDENTIAL Please tick appropriate box for the programme for which you are applying:

DEGREE/AWARD FULL-TIME PART-TIME

MA in Jewish Educational Leadership Graduate Diploma in Hebrew and Jewish Studies (Part 1) Graduate Diploma in Hebrew and Jewish Studies (Part 2) Postgraduate Diploma in Hebrew and Jewish Studies

1. PERSONAL DETAILS Family name Forenames Hebrew name

Address for correspondence

Telephone numbers Email address Home Work Mobile

Religion Nationality

Next of kin Address and tel. no.

1 2. CURRENT EDUCATIONAL ROLE (paid employment, voluntary, other) (For MA in Jewish Educational Leadership applicants only)

Name of synagogue/school/other institution

Position held

Describe role

If not currently working/volunteering in an educational setting, please state how you intend to gain your educational experience

Other relevant experience (optional)

3. DETAILS OF EDUCATION please list educational qualifications starting from the most recent

Schools/College/University Dates attended Qualifications and grades gained

Other further studies/training/ Dates Qualifications professional qualifications

Please attach photocopies of certificates and transcripts - certified translations are required for documents not in English

Do you intend to apply for Accreditation of Prior/Experiential Learning (AP(E)L)? Yes/No

(For MA in Jewish Educational Leadership applicants only) Please provide details of relevant past courses taken

Dates

Where

2 4. CAREER SINCE UNIVERSITY/COLLEGE (Optional)

Position Organisation Dates

5. LANGUAGE PROFICIENCY Good Fair Poor

Classical Hebrew

Modern Hebrew

Other languages State:

English

For students whose mother tongue is not English: Please provide proof of having met a minimum English language requirement of B2 on the common European framework of reference for languages (CERF) or a level 6 IELTS

6. ANY FURTHER DETAILS WHICH YOU FEEL MAY BE RELEVANT TO YOUR APPLICATION

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7. PERSONAL MOTIVATION FOR STUDYING AT THE COLLEGE (max. 500 words)

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8. GENERAL

Students applying for courses in Education which involve working with children and/or vulnerable adults must declare whether they have any criminal convictions, cautions (including verbal cautions), reprimands, final warnings, and bind-over orders. This includes convictions which are spent (as defined by the Rehabilitation of Offenders Act 1974)

Do you hold a DBS (previously CRB)?

If yes, date issued?

For what purpose?

9. HEALTH Please state your condition of health-giving details of any disability, medical condition or learning difficulty You are not obliged to disclose but if you wish the College to take your disability/condition into consideration please supply a doctor’s letter/certificate/diagnosis attesting to the above.)

10. CHECKLIST OF DOCUMENTS

Registration fee £50 for processing application (non- refundable) Please make the payment using: https://lbc.ac.uk/make-a-payment/ and click on the Rabbinic and Academic Awards Registration fee tab. Call the office on +44 (0)20 8349 5600 for other methods of payment)

2 current passport photographs

Photocopies of qualifications and grade transcripts

Proof of English proficiency (if English is not mother tongue)

Copy of passport pages containing personal information, nationality, etc.

Signed Date

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The College collects and holds your personal data as part of the admissions procedures and when you are a student. This will be used to create and maintain your student record, to provide you with educational and other services and to manage the College’s business. This information is held according to the Data Protection Act 1998 and from 25 May 2018 it will conform to the EU General Data Protection Regulation (GDPR). The College is required to share data about students with certain third parties such as funding bodies, sponsors, government departments and agencies and other educational providers. More details are included in the Student Privacy Notice.

______Signed

Please return completed application form by 30 June to

Sandy Potashnick College for Judaism 80 East End Road, London N3 2SY Tel: +44 (0)20 8349 5622 Email: [email protected]

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