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Course Detail

Enrolment Status :
Will your fees be funded by the Student Loan Company / Student Finance England? :
Residency Status :
EU Settlement Code :
Programme Group :
Course :
Intake :
Delivery Pattern :
This programme will run on one of the following site(s) :
Course Level :
Entry Level :
Course fee (GBP) :
First year fee (GBP) :
Title :
Forename 1 :
Forename 2 :
Forename 3 :
Preferred first name :
Surname/family name :
Previous surname/family name at 16th birthday :
Gender :
Email :
Are you applying for advance entry (APL) :
How did you hear about us? :

Personal Info

Mobile No. :
Nationality :
Dual Nationality :
Country of Birth :
Ethnic Origin :
Date of Birth :
Highest qualification on entry :
Your Highest Qualification :
Your last institution :
Institution Name :
HESA reference number :
Unique Learner Number (ULN) :
Share Code Reference Number :
Name of qualification :
Year achieved/obtained :
Subject :
Grade :
Passport No. :
Passport Expiry. :
Passport Place of Issuance :
Care Leaver :
Disability/special needs :
Currently Living in UK :

Permanent Home Address

House Number/Name and Street :
Address Line 2 :
City/Town :
County/State/Province :
Postal Code :
Country :
Phone No. :
Country of permanent residence :

Current Address

House Number/Name and Street :
Address Line 2 :
City/Town :
County/State/Province :
Postal Code :
Country :
Phone No. :

Next of Kin

Name :
Relation :
Phone No :
Email :

Reference

Referee Name :
Referee Univercity/Company :
Referee Position :
Referee Email :
Referee Phone No. :
Referee Mobile No. :
Referee Address 1 :
Referee Address 2 :
Referee Address 3 :
Referee City :
Referee Postal Code :
Referee Country :

Personal Info

Do you have any disability? :
If yes, please provide details :

Personal Statement

Declaration

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I agree to Anglia Ruskin University London (ARUL) processing personal data contained in this form or other data which ARUL may obtain from other people. I agree to the processing of such data for any purposes connected with my studies or my health and safety whilst on the premises or for any legitimate reason including communication with me following the completion of my studies. In addition, I agree to ARUL processing personal data described as Special Category Data as defined under the General Data Protection Regulation, such processing to be undertaken for any purposes as indicated in the declaration above. In addition to the Privacy Notice linked to this form please also see our Corporate Privacy Policy on our website - https://www.anglia.ac.uk/privacy-and-cookies .

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