Application Form - 2 year part-time BA (Hons) Professional Studies

Personal Details

Title (Mr, Mrs, Ms, Miss, etc):*

First name(s):*

Surname:*

Date of Birth (DD/MM/YYYY):*

Nationality:*

Home Address:*

Post Code:*

Telephone (Day):

Telephone (Evening):

Email Address:

Please Note: It is helpful for us to have your telephone number(s) and/or email address in case we need to contact you urgently about your application or course.

Disabilities

The University welcomes students with disabilities and strongly encourages you to disclose any disability or medical condition which may have an impact on your studies. Declaring a disability will not affect the academic decision about your application but will help us put any individual arrangements or facilities in place for the start of the course and enable us to monitor the effectiveness of our equal opportunities and diversity policies.

Do you have a disability/special need/medical condition RELEVANT to your application?*

Yes

No

If YES, please provide brief details below:

Ethnicity Monitoring

The information collected will be used for monitoring purposes only and will help the University to implement equal opportunities and diversity policies. Ethnicity data will not be used when assessing your application.

Please indicate your ethnic origin*

Criminal Convictions

The University requires you to state whether or not you have a criminal conviction. You do not have to declare a conviction that is classed as spent under the terms of the Rehabilitation of Offenders Act (please consult NACRO, Citizens Advice Bureau or a solicitor if you are unsure) or for motoring offences for which a standard fine or a maximum of three points was imposed. If you declare that you have a conviction you may be asked to provide details.

Do you have a criminal conviction NOT spent under the 1974 Rehabilitation of Offenders Act?*

Yes

No

Qualifications

Please state your previous highest qualification*

Please state your highest English qualification (and grade)*

Please state your highest Maths qualification (and grade)*

Please state the subject area of your Foundation Degree*

Please give the name of your Foundation degree institution*

Please give the month and year of your Foundation degree award*

Personal Statement

Please write a personal statement (of at least 300 words) stating your reasons for wanting to take this course, what you hope to gain by taking this course, and how this course relates to your long term professional/career goals.

Reference

Please give the name, email address, phone number, and position of someone who can provide a reference in support of your application. Ideally this should be your tutor from your Foundation degree course.

Name*

Email address:*

Referee phone number*

Referee's position*

Declaration

I confirm that the information given on this form is true, complete and accurate, no information requested or other material information has been omitted, and that I have completed the application myself. I agree that I have read the relevant application notes. I undertake to be bound by the terms set out in the application form and application notes and I give consent to the University of East Anglia to process the data (given by myself) I have supplied. I accept that if I do not fully comply with these requirements the University will have the right to cancel any application and that I shall have no claim against the University (in relation thereto) with regard to this. I agree to abide by the regulations of the University.

Agree to Declaration*

Yes

No