Continuing Professional Development 2024/25
Page
1
of
9
Personal Information
Title
--- Please Select ---
Dame
Doctor
Dr
Hons
Miss
Mr
Mrs
Ms
Name
First Name
Last Name
Select the gender that you most identify with at this time
Male
Female
Transgender
Non-Binary
Prefer not to disclose
Other
Contact Number
Correspondence e-mail
Additional e-mail
Birth
Date of Birth
Country of Birth
Afghanistan
Algeria
American Samoa
Angola
Anguilla
Antarctica
Armenia
Australia
Austria
Azerbaijan
Bahamas, The
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Bermuda
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Burundi
Cambodia
Cameroon
Canada
Canary Islands
Cape Verde
Cayman Islands
Channel Islands
Chile
China
Colombia
Congo
Costa Rica
Croatia
Cyprus
Czech Republic
Czechia
Denmark
Dominica
Ecuador
Egypt
England
Estonia
Ethiopia
Finland
France
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Grenada
Guernsey
Guinea
Guyana
Haiti
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Irish Republic
Isle Of Man
Israel
Italy
Ivory Coast [Côte D'Ivoire]
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Libya
Lithuania
Luxembourg
Macau
Malawi
Malaysia
Maldives
Malta
Mauritius
Mexico
Moldova
Mongolia
Morocco
Mozambique
Myanmar
Namibia
Nepal
Netherlands
New Zealand
Nigeria
Northern Ireland
Norway
Oman
Pakistan
Panama
Papua New Guinea
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saudi Arabia
Scotland
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
St. Kitts & Nevis
St. Lucia
St. Vincent & Grenadines
Sudan
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tanzania
Thailand
Trinidad And Tobago
Turkey
Turks And Caicos Islands
Uganda
Ukraine
Union Of Soviet Socialist Repu
United Arab Emirates
United Kingdom
United States
United States Of America
Vatican City
Vietnam
Wales
West Indies
Yemen
Zambia
Zimbabwe
Address
Primary Address
Address
City / Town
Region
Country
Postcode
Do you wish to provide an additional address?
Yes
No
Additional Address
Address
City / Town
Region
Country
Postcode
Leeds Beckett
Have You Previously Studied at Leeds Beckett University?
Yes
No
Leeds Beckett Student ID
Should be eight characters long starting with 77,11 or 33
Immigration
Do you require Immigration Permission to study in the UK?
Yes
No
Please specify
I am British citizen
I am an EU National and I have been granted settled/pre-settled status
A member of my family is a British citizen
Other
Immigration No Other
Page
1
of
9
Next
