The Digital Interview Form (18-19)

BCNH Digital Interview Form (18-19)

(please provide as much information as you can)
Date: *

- Day - Month Year
DD-MM-YYYY
Personal Details

(please complete all the fields below)
Name: *

Forename/s Surname
Gender: *

Male Female
Date of Birth: *

- Day - Month Year
DD-MM-YYYY
Email *
Telephone No: *

- Area Code Phone Number
Address: *
Nationality *
Country of Domicile *
What is your current job / profession? *
Your Ethnic Origin

(for statistical analysis only)
Please, tick check below

Caucasian Asian Black African Black Caribbean Chinese
Health Problems or Disabilities

(please answer as accurately as you can)
Do you have any health issue or disabilities?

Yes No
If the answer is YES, please explain below (e.g. hearing impairment, blind / partially sighted, epilepsy, mental health difficulties, etc.):
BCNH Courses

(please tick the course are you applying for)
Course Name *

Standard Science Foundation Course (SFC) Refresher SFC Level 6 Diploma in Nutritional Therapy
Study Mode: *

Attendance Distance Learning (online)
Financing Your Studies

(please answer as accurately as you can)
How do you intend to finance your studies?

Personal savings Career Development Loan (CDL) Personal loan Sponsorship Other - please explain below
If applicable, briefly explain OTHER means of financing:
Are you aware that BCNH fees can be paid by monthly or quarterly instalments?

Yes No
About your Educational Background

(please answer as accurately as you can)
How long has it been since you studied?

Less than 10 years 10 - 15 years More than 15 years
Do you have basic computer skills (e.g. Microsoft Office)

Yes No
Please, tick if you have a minimum of: *

5 GCSEs (grade C and above, including Maths & English) A-level Chemistry or Biology An equivalent to A-level in Chemistry or Biology
If you have a qualification equivalent to an A-Level in Biology or Chemistry (e.g. from another country), please explain below:
Have you attended a tertiary education previously (e.g. a University or Open University?)

Yes No
If YES, please give brief details of your University studies below:

List any academic qualifications that you may have:

	Award	Title	Date of Award	Where studied (incl. country)
1
2
3
4
5

About Your Study Habits

(please answer as honestly as you can)
Briefly explain how you ensure that you meet deadlines?
How do you cope with tests and examinations?
If English is NOT Your First Language

(a couple of fact-finding questions)
Have you completed the IELTS examination with a score of 7 or above?

Yes No n/a - English is my first language
Are you aware that to enrol on a BCNH course you will need to complete the IELTS examination with a score of 7 or above for each of the 4 individual components (Reading, Writting, Speaking and Listening)?

Yes No n/a
Your Market Research

(BCNH and other colleges)
How did you hear about BCNH? *

Personal recommendation Facebook Twitter Internet Search NTEC website BCNH Open day / Open evening BCNH student / graduate Other (please explain below)
If Personal Recommendation or Other, please explain below:
What other nutrition colleges have you investigated while looking for a suitable course?
Having done your market research, why would you wish to study at BCNH?
About Studying at BCNH

(a few fact-finding questions)
Are you aware that BCNH students can join lectures and seminars live online?

Yes No
Are you aware that BCNH lecture and seminar video recordings are available for you to watch in your own time?

Yes No
Are you aware that students can post course-related questions on an online forum and receive a response from a course tutor?

Yes No
Are you aware that your studies are monitored and supported by the BCNH Programme Leader?

Yes No
Are you aware that all BCNH students are allocated a personal tutor?

Yes No
Are you aware that your personal tutor will provide comprehensive written feedback on your course assignments and will be available to discuss this feedback?

Yes No
About Studying Nutritional Therapy

(a few fact-finding questions)
Why do you wish to study nutritional therapy? *

Career change Personal interest
What is your PERSONAL experience of nutritional therapy?
Briefly explain what you intend to do with your nutritional therapy qualification:
What is your understanding of the difference between nutritional therapy and dietetics?
Are you aware of the employment prospects once you qualify as a Nutrition Practitioner?

Yes No Tell me more about it
About the Science Foundation Course (SFC)

(a few fact-finding questions)
Are you aware that the BCNH SFC is just below A-level standard?

Yes No n/a - I do not need to enrol on the SFC
Are you aware that the SFC is custom-designed to give you the foundation you need for BCNH studies and, as such, may or may not be recognised by other institutions?

Yes No n/a
Can you spare 7-10 hours per week for SFC study?

Yes No n/a
How would you rate your level of commitment to the SFC course on a scale of 1 to 10; 1 being not very committed and 10 being very committed?

1 2 3 4 5 6 7 8 9 10 n/a
Level-6 Diploma in Nutritional Therapy

(a few fact-finding questions)
Are you aware that the BCNH Level-6 Diploma is taught at degree-level?

Yes No
Are you aware that the BCNH Level-6 Diploma is credit-rated by the University of Greenwich and awarded 195 credits by the University?

Yes No
Are you aware that the BCNH Level-6 Diploma is evidence-based and incorporates the key principles of Functional Medicine?

Yes No Tell me more about it
Are you aware that the BCNH Level-6 Diploma requires, on average, 15 hours per week for independent study (in addition to lecture and seminar attendance, live or online)?

Yes No Tell me more about it
Can you fit the Level-6 Diploma course into your present lifestyle?

Yes No I will try
How would you rate your level of commitment to the Level 6 Diploma course on a scale of 1 to 10; 1 being not very committed and 10 being very committed?

1 2 3 4 5 6 7 8 9 10
Clinical Training at BCNH

(a few fact-finding questions)
Are you aware that clinical training at BCNH starts with the very first module?

Yes No Tell me more about it
Are you aware that BCNH clinical training is based on Functional Medicine principles?

Yes No Tell me more about it
Are you aware that UK-based online students are required to physically attend 1 weekend of clinical training in Year 3?

Yes No Tell me more about it
Are you aware that ALL students (including international students) must physically attend at least 1 weekend of clinical training in Year 4?

Yes No Tell me more about it
Are you aware that Year 4 students are required to complete a minimum of 15 live consultations, with real clients, under BCNH supervision?

Yes No Tell me more about it
Are you aware that Year 4 students are required to complete a minimum of 10 written client reports?

Yes No Tell me more about it
Are you aware that Year 4 students are required to write a minimum of 3 referral letters to their client's doctors (GPs)?

Yes No Tell me more about it
Are you aware that online students can have their live consultations supervised and assessed via Skype?

Yes No Tell me more about it
Criminal Convictions

(you must tick YES if you have any criminal convictions (please note minor criminal offences (e.g drink driving, are unlikely to be considered relevant if you choose to enrol on a BCNH course)
Do you have a criminal record?

Yes No
If YES, was it within the last 5 years?

Yes No
If YES, was it within the last 5 years?

Yes No
Candidate Declaration & Consents:

I confirm that I confirm that I have read the Interview Form 2018 – 2019 and the information above is true and correct at the time of completing this form. I am satisfied that appropriate information about the courses has been made available to me in the BCNH Prospectus and / or BCNH website.
I hereby give consent for my contact information to be shared for BCNH’s marketing purposes, including the distribution of newsletters and other information which BCNH reasonably considers may be of interest to me:

Yes No
Consent re: information retained by BCNH

I hereby give consent for the information contained in this form, including in the Ethnic Origin, Health Problems or Disability and Criminal Convictions sections of this Agreement, to be retained by BCNH (held in hard copy and electronically), solely and exclusively in order to determine my suitability for a BCNH course.
I understand that this information will not be passed on to any third party without my express consent.

Yes No
I understand that, should I wish to withdraw either of these consents, I can do so at any time by emailing the college at admin@bcnh.co.uk, stating I no longer consent for my personal information to be used for any purpose.
Data Protection Statement

BCNH Complies with the General Data Protection Act 2018. At no time will your personal information be passed to organizations for marketing or sales purposes.
Candidate e-signature *

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BCNH Digital Interview Form (18-19)

Personal Details

Your Ethnic Origin

Health Problems or Disabilities

BCNH Courses

Financing Your Studies

About your Educational Background

About Your Study Habits

If English is NOT Your First Language

Your Market Research

About Studying at BCNH

About Studying Nutritional Therapy

About the Science Foundation Course (SFC)

Level-6 Diploma in Nutritional Therapy

Clinical Training at BCNH

Criminal Convictions

Candidate Declaration & Consents:

Consent re: information retained by BCNH

Data Protection Statement

For Office Use Only: