Leading AI and Industry 4.0: Application | Exec Ed

Open Programme Application Form

ABOUT THE PROGRAMME

Your chosen programme

Promotional code

Where did hear about us?

Please specify if other

ABOUT THE APPLICANT

Title

Family Name

First Name

Known as

Emergency contact person and phone number

Special dietary requirements

Special access needs

Gender

Nationality

APPLICANT CONTACT DETAILS

Mobile

Telephone

2nd Email (or Assistant)

Street

City

Country

Zip / Post Code

APPLICANTS CAREER DETAILS

Occupation

If 'other', please specify

Company

Company size (number of employees)

Sector / industry

Years of experience

Describe your responsibilities within the organisation

Describe your learning objectives

L&D DIRECTOR DETAILS (OR EQUIVALENT)

Please complete this section if you are an HR or L&D head/director completing this application on behalf of the applicant, because the company is sponsoring this application.

Name

Job title

Telephone

INVOICING

If you are offered a place on the programme, an invoice will be issued once you have accepted our offer.

If you wish this invoice to be addressed and sent to someone other than yourself (e.g. your Finance department, HR manager etc.), please complete the information below. Alternatively, you can pay online in the City, University of London e-store.

Please select your payment method:

Send an invoice to me personally at the address provided in this applicationSend an invoice to another person as specified below (please provide correct email address)I prefer to pay online using the e-store

Invoicing Details:

FAO	Email
Telephone	Purchase order no.
Company	Street
VAT number (EU based only)	City
State/Province	Zip/Postcode
Country

Notes (Please notify us of discount eligibility or any additional details.)

By ticking this box, you consent to join our mailing list. We’ll keep you updated with relevant news, events and information about your chosen programme to support your application and decision-making. You can unsubscribe at any time.

By ticking this box, you are choosing to remain unsubscribed from our mailing list.

Please complete the details below to confirm your consent for us to contact you.

In processing your personal data to respond to and follow up on your enquiry, we will do this securely and only use the information for your chosen purposes. We will never sell, rent or lease it to 3rd parties. Please read our full privacy notice here. To talk to us about how we use your information or report a concern please email DataProtection@city.ac.uk.

TERMS & CONDITIONS

Please read our full terms and conditions here.

By ticking this box, I confirm that I have read, and agree to the terms and conditions.