Family name: 

Given name(s) (and/or initials): 

Primary email address (e.g. j.smith@bbk.ac.uk): 

Country of work/residence (please enter uppercase 2-letter ISO-3166 code, e.g. GB, US, DE, FR, etc.): 

Title of degree obtained (e.g. BSc Physics, PhD Mathematics): 

Your level of education: Postgraduate Postdoctoral Lecturer-Professor Professional Other

Have you fully browsed the material giving details of the course? Yes No

Have you filled in, signed and posted (or faxed) the College Application Form? Yes No

Technical

We will need to know the level of your technical experience in order to assess the level of support you will need.
Please indicate your computing background below being as detailed as possible:

[Warning: Do not fill box with more than 240 characters otherwise the message may not be accepted.]

Do you have regular access to a networked computer? Yes No

If applicable, what type of platform is it (e.g. PC running Windows 95)?

Any additional details (e.g. 16Mb RAM, 15" screen)?

Do you have regular access to a Web browser (e.g. Netscape 3.0 or Internet Explorer 3.0) on the computer? Yes No

If applicable, please type browser name and version in here:

Do you have access to local technical support in respect of computer matters? Yes No

Are you able to download software and files? Yes No

Do you have your own homepage where you could mount material? Yes No

If applicable, please type in the URL here:

Do you have any of the following installed on your local machine?

Telnet Yes No   FTP Yes No