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PROVISIONAL MODULE SELECTION FORM
Academic Year 20____ - 20____ ( Autumn ( Spring
Students Name:
Students Home Institution:
Field of Study:
Email Address (in Capital) ..
Section 1: DETAILS OF THE PROPOSED STUDY PROGRAMME
Please enter your module choices below for the academic term/year at Brunel. Since some modules may not be available for you to take, we encourage you to list additional modules. Please be advised that there is no guarantee that you will be able to enrol in all of the modules you have selected. You will have an opportunity to discuss your choices during the induction week and finalise your selection. Full time students need a total of 120 credits (6 modules) for a full academic year or 60 credits (3 modules) for a single term (most undergraduate modules are 20 credits each unless otherwise noted).
Please return the form with your latest academic transcript in English.
91ӰDepartment (i.e. English)Module CodeModule NameCredits
Section 2: 91ӰStaff ONLY
91ӰAcademic Exchange Coordinators Comments
91ӰDepartment Approval
I confirm that the proposed programme of study is provisionally approved.Academic Exchange Coordinators Name
Date: Academic Exchange Coordinators signature
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