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Higher Education Enrolment Form

Personal Details

Qualifications

Widening Participation

Terms


Personal Details

Legal Surname*
Legal First Forename*
Other Forenames
Known As (If different to your Legal First Name). This will be on your ID Card and Registers
Title*
Date of Birth*
Legal Sex*
Preferred Gender (if not your legal sex)
National Insurance (NI) Number
Mobile* (with no spaces and usually starts with 07)
Personal Email Address*

Additional Information

UCAS Number
Last Institution
Please select what best describes your socio-economic class (if under 21 years, your parents socio-economic class*)

Home Address

No. & Street*
Town/City*
County
Number of years lived at current address*
What is your country of Residence*

Equality and Diversity

Nationality*
What do you consider to be your Ethnicity*
How would you describe your religious status*
How would you describe your sexual orientation*
Have you lived continuously in the UK for more than 3 years on the first day of your course?

If you have not been a resident of the UK for 3 years you may not be entitled to funding - we will need to collect more information from you to determine your eligbility

Visa Type
Date of Entry into the UK (If non UK or EU resident)
What country did you arrive from?
Visa Expiry Date
Accomodation Type*

Term Time Address

If you are living away from home during your studies, please provide the details of your Term Time address below

No. & Street
Town/City
County

Parent/Guardian/Carer Emergency Contacts

We use these in an emergency or if we cannot contact you by any other means.

Primary Contact

First Name*
Surname*
Phone Number*
Email Address
Relationship to you*
Do you live with the contact

Secondary Contact

First Name*
Surname*
Phone Number*
Email Address
Relationship to you*
Do you live with contact

Support

Do you consider yourself to have a learning difficulty, disability and/or health problem that could affect your learning or use of the facilities at the School?*