Sunderland App PDF
Sunderland App PDF
Sunderland App PDF
Programme:
Universitytoofthe
welcome
Sunderland
first stage
of changing Form
Application
your life
Application
Time
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Section 8 Disability
Physical or other disability or medical condition including any which might
necessitate special arrangements or facilities.
Disabilities/support required:
0 You do not have a disability nor are you aware of any associated additional support requirements in study or accommodation.
1 You have a specific learning difficulty eg dyslexia.
2 You are blind/partially sighted.
3 You are deaf/have a hearing impairment.
4 You are a wheelchair user/have mobility difficulties.
5 You have Autistic Spectrum Disorder or Asperger Syndrome.
6 You have mental health difficulties.
7 You have an unseen disability, eg diabetes, epilepsy, asthma.
8 You have two or more of the above disabilities/special needs.
9 You have a disability not listed above.
If you have any disability or medical condition which may mean that you
need special arrangements for your studies, please contact our Disability
Support Team (tel: 0191 515 2933), before completing the application form
to ensure that the facilities you need will be available.
Section 13 Declaration
Any offer of a place you may receive is made on the understanding that in
accepting it you agree to abide by the rules and regulations of the university
and by signing this form you are confirming your agreement to this.
By signing this form you are saying that the information you have provided is
accurate and complete. Any offer of a place you may receive is made on the
understanding that, in accepting it, you agree to abide by the rules and regulations of the institution.
The university reserves the right to disclose information given in your application form to outside agencies, eg Police, Home Office, Local Authorities,
Examining Boards, Department of Social Security, the Student Loans
Company.
If the university has reason to believe that you or any other person has omitted any mandatory information requested in the instructions or the application form, has made any misrepresentation or given false information, the
institution will take whatever steps it considers necessary to establish
whether the information given in your application is correct. The institution
reserves the right at any time to request that you, your referee or your
employer provide further information relating to any part of your application
form, eg proof of identification, status, academic qualifications or employment history. If such information is not provided within the time limit set or if
that information is not satisfactory, the institution reserves the right to cancel
your application.
Course Code:
Offer:
Conditions:
Agent Code:
Please read the Notes for Applicants overleaf before completing this form. Write neatly using black ink or typescript.
!
Level of Entry: Undergraduate !
Postgraduate !
Full-Time
Year:
Part-Time
Distance Learning
Research
MPhil/PhD/Prof
Title: Mr
Gender: Male
Mrs
Miss
Female
Ms
Email:
Postcode:
Date of Birth:
(eg 02.03.71)
Postcode:
Country of Birth:
Country of Residence:
Nationality:
Result:
Date of Test:
Month:
Year:
3. Continued
Examinations/Qualifications. (in chronological order) (continue on a separate sheet if necessary) course, examinations and qualifications completed and those
still waiting for results.
From
To
Month/Year
Month/Year
Qualification
Subject/Title
Educational Establishments
Please provide the names of the last two educational establishments attended
Institution
(Place of study)
Dates
.
From
To
Main Responsibilities
Full/Part-Time
From
To
Month/Year
Month/Year
6. References
You are required to provide two references if applicable. One academic (for example teacher/college lecturer) and one professional (for example employer).
References from family members or friends are not acceptable. The references may be sent together with the application form or directly from the referee to
the admissions office at the address given in box 13. Please note that mature/work-based applicants need only provide a professional reference.
7. Fees
If you are living in the European Union but were born outside the EU please state date of first entry to the EU and your reasons for being here.
Family Member
Sponsor
Employer
10. Equal opportunities monitoring information (See section 10 of Notes for Applicants)
Ethnic origin
Please choose from the ethnic origin terms the one which you feel most closely describes your ethnic origin and write the code in the box
School
12. Checklist
!
!
Applicants Signature:
Date:
Please return this form to: University of Sunderland, Admissions, The Gateway, City Campus, Chester Road, Sunderland, SR1 3SD, United Kingdom.
Helpline Telephone: +44 (0) 191 515 3000 Email: student-helpline@sunderland.ac.uk www.sunderland.ac.uk
JAN 2007