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6 Examinations
Pleaselistresults,includingthosepending,andattachphotocopiesofyourcertificatesortranscripts.
LevelegGCSE/Degree Subject Date(mm/yyyy) Institution Result
4 Work experience
5 Last two educational establishments attended
Givedetailsofworkexperience,trainingandemployment.Continueonaseparatesheetifnecessary.
Givenamesandaddressesofthelasttwoeducationalestablishmentswhichyouattended.
Jobtitle NameofOrganisation Full-orpart-time From(mm/yy) To(mm/yy)
Establishment Full-orpart-time From(mm/yy) To(mm/yy)
www.beds.ac.uk November2010
HaveyoupreviouslystudiedattheUniversityofBedfordshire(orLuton/DMUBedford)?YES/NO
Ifyes,pleaseprovidedetailsofthecourse(title)
Formerstudentreferencenumber
IfyouhaveQualifiedTeacherStatuspleasegiveusyourTeacherreferencenumber
www.beds.ac.uk November2010
7 Additional needs
Pleaseindicateifyouhaveadisability:
Nodisabilityn AutisticSpectrumn VisualImpairmentn HearingImpairmentn Long-termHealthn
MentalHealthn Dyslexian WheelchairUsern Otherdisabilitynotlistedn Multipledisabilityn
Pleasegivefurtherdetailsofanysupportneedswhichmightnecessitatespecialarrangementsorfacilities:
8 Names of referees
9 Further information
Pleasegivethenamesandcontactdetailsoftwopeoplewhocancommentonyoursuitabilityforthiscourse,whichcouldincludeateacher,anacademictutor,currentemployer,workexperienceco-ordinator.
Pleaseusethissectiontotellusaboutyourselfandyourreasonsforwantingtostudythiscourse.Youmayprefertoattachaseparatestatement.
Name Name
Organisation Organisation
Telephone Telephone
Fax Fax
Email Email
Relationshiptoyou Relationshiptoyou
Notes for guidance
IMPORTANT NOTETheUniversityofBedfordshirewilltakeallreasonablestepstoprovidetheeducationalservicesetoutinitsprospectuses.ShouldindustrialactionorothercircumstancesbeyondthecontroloftheUniversityofBedfordshireinterferewithitsabilitytoprovidesuchaservice,theUniversityofBedfordshirewilltakereasonablestepstominimisetheresultantdisruption.TheUniversityofBedfordshiredoesnotundertakeanyabsoluteobligationwhatsoevertoprovideaneducationalserviceinthemannerspecifiedinitsprospectusesorinanyotherdocument,nordoesitundertakeanyotherobligationinrespectoftheprovisionofaneducationalservicewhichismoreonerousthantheobligationssetouttherein.
ShouldyoubecomeastudentoftheUniversityofBedfordshire,thisnoticeshallbeatermofanycontractbetweenyourselfandtheUniversity.AnyofferofaplacemadetoyoubytheUniversityofBedfordshireismadeonthebasisthatinacceptingsuchanofferyousignifyyourconsenttotheincorporationofthisnoticeasatermofanysuchcontract.
General
Beforecompletingtheform,pleaseensurethatyoureadthesenotescarefully.YoushouldalsoreadthecurrentUniversityofBedfordshireliteraturerelatingtothecourse(s)inwhichyouareinterested.TheUniversity’sregulationsaretobefoundatatwww.beds.ac.uk/aboutus/quality/regulations.
StudentswithExperience
TheUniversityofBedfordshirewelcomesapplicationsfromstudentswithexperience,includingthosewhodonothaveconventionalqualificationsforadmissiontohighereducationintheUK.Fullaccountistakenofrelevantexperienceandothereducationalachievements.
TheDataProtectionAct1998
Theinformationwhichyougiveonyourformwillbeusedforthefollowingpurposes:
•TodetermineyoureligibilityforentrytotheUniversityofBedfordshire.
•ToenabletheUniversityofBedfordshiretocompilestatisticalreports.
•ToenabletheUniversityofBedfordshiretoinitiateyourstudentrecord.
•Toshareinformationwithgovernmentdepartments(egimmigrationoffice),localauthoritiesandotherbodiestopreventpossiblefraudandtoenablethemtocarryouttheirfunctions.
Section1Personaldetails
CompletethissectioninBLOCKCAPITALS.
Section2Detailsofthecourse(s)youwishtoattend
Ifyouwishtoindicateanorderofpreferenceforyourcoursechoicesyoumaydoso.Ifyoudonotindicateanorderofpreferencethenitwillbeassumedthatyouhavenone.
Section3Feestatus
Pleasestateyourcountryofpermanentresidenceandgivedetailsofwhoyouexpecttopayyourfeesfortheproposedcourse.
Section6Examinations
Entertheexactsubjectnameusedbytheexaminingbodyandthenameoftheexaminingbodyinfull.IfyouhavequalificationsobtainedoutsidetheUK,youshouldgivedetailsofallexaminationstakenaspreparationforentrytohighereducation(egSchoolandHigherSchoolCertificate,Apolytirion,Baccalaureat).ApplicantswithqualificationsobtainedinalanguageotherthanEnglishmustattachacertifiedEnglishtranscripttotheform.
Section7Additionalneeds
Describeyourconditionand,whereitisnotobvious,indicatewhetheryouhavespecialneeds.
10 Declaration and submission
Weexpectyoutosubmitacompleteandcomprehensiveapplicationatthepointoffirstsubmission.Thiswillenableustoproperlyassessyoursuitabilityforthecourse.Itisthereforeinyourbestintereststoprovideuswithaccurateinformationandtoensurethatyouarefullyinformedaboutthecourseyouareapplyingforandthecommitmentsyouwouldbemakingifyoubecomeastudenthere,andtoensurethatyouhaveattachedcopiesofyourqualificationsandtwosuitablereferences.Bysigningyourapplicationyouareconfirmingthattheinformationprovidedonthisformiscompleteandcorrect.
Iconfirmthat,tothebestofmyknowledge,theinformationgiveninthisformiscorrectandcomplete.
Applicant’ssignature Date
Please return the completed form to:Admissions Admissions University of Bedfordshire University of Bedfordshire Park Square Polhill Avenue Luton Bedford Fax: +44 (0)1582 489323Bedfordshire Bedfordshire Email: [email protected] 3JU MK41 9EAEngland England www.beds.ac.uk