Fillable Application Form Please complete the below form and (University of Northampton)

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Application Form Please complete the below form and (University of Northampton)

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Application Form
Please complete the below form and return to
intadmissions@northampton.ac.uk
If completing the form by hand, please print clearly
in black ink and BLOCK CAPITALS
2. Course(s) applied for.
First choice Start date Month Year
Point of entry (i.e. year 1, 2 or 3)
Mode of Study Full-time Part-time Distance
Level of Study Undergraduate Postgraduate (taught) Research
Second choice Start date Month Year
Point of entry (i.e. year 1, 2 or 3)
Mode of Study Full-time Part-time Distance
Level of Study Undergraduate Postgraduate (taught) Research
1. Personal Details.
Family name as appears in passport
First name(s) as appears in passport
Title (Mr/Mrs/Miss/etc) Previous family name (if applicable)
Date of birth Male Female Other
Home/permanent Correspondence address or
address addressofUniversityRepresentative(ifdierent)
Postcode Postcode
Country Country
Tel no. Tel no.
Mobile Mobile
Email Email
Nationality (if dual please give both) Country of birth
Country of permanent residence (if UK give County/Borough) Entry date to UK
- -
- -
*PT = part-time, FT = full-time, DL = distance learning
3. Previous and present education.
Please list details of all institutions attended since age 11.
Name and address of institution From (mm/yy) To (mm/yy) Study mode PT/FT/DL*
5. Academic qualications - examinations pending.
Complete this section only if you are awaiting the result of any examination taken recently.
Exam date (mm/yy) Awarding body Subject Qualication
4. Academic qualications - examinations achieved.
Pleaselistallqualicationstaken,whatevertheresult,inchronologicalorder.Documentaryevidenceofknownresults
shouldbesentwiththisform.Onlycertiedphotocopiesareacceptable.
From (mm/yy) Awarding body Subject Qualication Results achieved
Select
Select
Select
Select
6. Previous study in the UK (for overseas (non-EU) applicants).
TheHomeOcehasintroducedalimittothetimethatinternationalstudentsonaTier4StudentVisacanspend
studying at degree level. There will be a general limit of 5 years on study time but this will not apply to those studying
for Master’s degrees following successful completion of an undergraduate degree where the undergraduate course
durationwas4or5years.Inthesecasesthelimitwillbesetat6years.Wealsohavetoensurethatanystudyyouare
proposing to undertake represents academic progression from any previous studies in the UK.
In view of this new policy it is essential that you answer the following question:
Have you ever studied previously in the UK? Yes No
If yes, please list below any previous study (regardless of the level i.e. English language courses) undertaken in the UK.
Wewillalsorequirecopiesofallvisasheldduringthoseperiodsofstudy.
If you have previously been a student at the University of Northampton please give your student ID number.
DoyourequireaTier4visatostudywithus?YesNoIfno please provide us with a copy
of your current visa.
Institution Course studies and level
i.e. foundation/degree etc
Start and completion of
course
Type of visa held during
period of study
7. English language.
All international students applying for a course at the University of Northampton must meet the minimum English
languagerequirements,however,ifyoudonotmeettheserequirementsweoerpre-sessionalacademicEnglish
language courses and an international foundation programme.
For more information visit: www.northampton.ac.uk/study/international-students/english-language-requirements
Please give full details, including dates, of any English tests taken/to be taken:
Level
Wherestudied University/College/Awarding body Date taken (mm/yy) Results
8. Work experience. (if applicable to course application)
Please give details of work experience, training and employment.
Dates from
(mm/yy)
Dates to
(mm/yy)
FT/PT* Post held Organisation name and address Brief description of
duties
* FT = full-time, PT = part-time
9. Finance and fee status.
Allstudentsoeredregistrationwillbeaskedtosupplydetailsoftheirnancialposition,lettersofguaranteefrom
sponsorsetc,toensurethattheycancompletethecoursewithoutnancialhardship.
Whowillbepayingyourfees?
Self Sponsor
Student Finance England
Employer Please give details
Please give details of any scholarship grant application giving name, value and duration.
Already awarded Please give details
Application made Please give details
10. Declaration of a criminal conviction.
Only complete this section if you are applying for a course that requires a Disclosure and Barring Service (DBS)
check, which can be conrmed by checking the course entry requirements on our website.
Please indicate if you have a relevant criminal conviction by ticking in the box Yes No
Applicants who answer ‘Yes’ will not be automatically excluded from the application process, and their application
will be considered on its merits before the relevance of their criminal conviction is taken into account. However, the
Universitymayaskformoreinformationabouttheircriminalconvictionbeforemakinganaldecision.
Ifyouareconvictedofarelevantcriminaloenceafteryouhaveapplied,youmusttellus.Donotsenddetailsofthe
oence;simplytellusthatyouhavearelevantcriminalconviction.TheUniversitymaythenaskyouformoredetails.
Select
Select
Select
Select
11. Personal statement/further information.
Please use this section to tell us about yourself and your reasons for wanting to study this course.
Please continue on a separate sheet if necessary.
12. References.
Please read the guidance notes carefully. Please note that it is your responsibility to send Part B – Statement by
Referee-toyourrefereesforcompletion.Wewillnotbeabletomakeadecisionaboutyourapplicationuntilwe
receive your references, one of which must be an academic reference if you have recently completed a school or
university course.
Referee 1 - Academic Referee 2
Name Name
Address Address
Postcode Postcode
Tel No. Tel No.
Fax No. Fax No.
Email Email
Capacity in which applicant is known to the referee Capacity in which applicant is known to the referee
For how long For how long
Please note, references should not be provided by close family members or friends.
13. Disabilities/special needs.
Please tick the appropriate box(es) and in the space at the bottom of this section indicate any additional support
or facilities that you may need at the University. This information will be made available to ASSIST who can support
applicants through the admissions process and agree adjustments for their studies. Information you disclose about
your disability will be used in accordance with the University’s Admissions Policy.
You can access this at www.northampton.ac.uk/more/governance-and-management/university-policies-
procedures-and-regulationsandndinformationaboutDisabilityServicesatwww.northampton.ac.uk/study/
student-life/support
No known disability Autistic Spectrum Disorder/Asperger’s Syndrome
Blind or a serious visual impairment Long standing illness or health condition
Deaf or a serious hearing impairment Mental health condition
Twoormoreimpairmentsand/or Wheelchairuser/mobilitydiculties
disabling medical conditions
SpecicLearningDiculty(egDyslexia) Otherdisabilitynotlistedabove
I am in receipt of the Disabled Students’ Allowance Yes No
I am applying for or intend to apply for the Disabled Students’ Allowance Yes No
Please detail below any additional support, adjustments or changes you may need for your studies
How did you hear of the University of Northampton?
Declaration.
By providing this information you acknowledge that the University will need to process such Personal Data to enable
the review of your application. To allow for the lawful processing of your personal data, we need your consent. Please
signtoconrmthatyouagreetosuchprocessingandtoallowustoconsideryourapplication.
As an international applicant the processing of your data will include the University sharing your Personal Data
andspecialcategoryPersonalDatawithUKVisasandImmigration(UKVI),whichwillenablethemtoconrmyour
immigration history. Such sharing is a legal requirement.
You also acknowledge that should you not meet the entry requirements of your chosen course at the University,
you consent to the University sharing your Personal Data and special category Personal Data with our partner
college, University of Northampton International College (UNIC) in order for you to be considered for an alternative
programme of study at UNIC.
In completing and submitting your application form, you will be providing the University of Northampton with
personaldata,includingspecialcategorydata,asdenedintheDataProtectionAct2018andtheGeneralData
ProtectionRegulation(GDPR)((EU)2016/679).TheUniversitywillusethisdataforprocessingyourapplicationandit
maybesharedwithseveraldepartmentswithintheUniversity.TheUniversitypolicyonDataProtectionandGDPR
compliance can be found at: www.northampton.ac.uk/about-us/services-and-facilities/records-management/data-
protection-act
And for more detail on how the University processes personal data please see our Privacy statements at:
www.northampton.ac.uk/about-us/privacy-policy
This personal data may also be shared with and used by third parties in connection with the above purposes, for
exampleinordertoverifyyouridentity,qualications,workexperienceandotherinformationthatyouprovide,or
so that the University can comply with its obligations to supply certain information to the Higher Education Statistics
Agency,DepartmentofEducation,UKVIandotheragencies.Incertaincircumstancesincludingthepreventionand
detection of crime, details may be provided to the Police or other relevant lawful authority. Such processing is lawful
underthetermsofGDPRArticle6andArticle9.
Some of these third parties may be located outside the European Economic Area but the University will where
possible ensure that they abide by the relevant UK legislation.
I declare that I understand the statement regarding the use by the University of my personal data. I further declare
that the information on this form is correct to the best of my knowledge. I understand that if I have been found to
have deliberately and seriously misled the University about the details on this form I could be asked to withdraw from
my course.
Signed Date
Please return completed applications to:
InternationalOce,UniversityofNorthampton,NewtonBuilding,StGeorge’sAvenue,Northampton,NN26JB,UK
or email to: intadmissions@northampton.ac.uk.
Select
Part B - Statement by referee.
To be completed by applicant.
Applicant’s full name
Course
(see website for title: northampton.ac.uk)
Date of birth Male Female Other
Name and address to which reference is to be sent (i.e. your address)
Postcode Country
Email
Notes for the guidance of referees
A referee must be able to comment on academic ability and must not be related to the applicant. The reference
should include the following:
How long and in what capacity has the referee known the applicant?
How do you assess the applicant’s academic/intellectual ability? (It would be helpful if, in the case of a graduate,
referees could indicate whether they consider the class of degree achieved fairly represented his/her calibre).
Whatarethestrengths/weaknessesoftheapplicant?
Any further relevant information.
- -
To be completed by the referee.
Thisformmaybephotocopied:pleasetypeifpossible,orwriteinblackink.Pleaseaxanocialstamp,where
appropriate, at the end of the statement
Name of referee
Post/Occupation/Relationship
How long have you known applicant
Name of School/College/Organisation
Address
Postcode Country
Tel No. Fax No.
Email
Name of applicant (block capitals or type)
Signed Date
Part B - Statement by referee.
To be completed by applicant.
Applicant’s full name
Course
(see website for title: northampton.ac.uk)
Date of birth Male Female Other
Name and address to which reference is to be sent (i.e. your address)
Postcode Country
Email
Notes for the guidance of referees
A referee must be able to comment on academic ability and must not be related to the applicant. The reference
should include the following:
How long and in what capacity has the referee known the applicant?
How do you assess the applicant’s academic/intellectual ability? (It would be helpful if, in the case of a graduate,
referees could indicate whether they consider the class of degree achieved fairly represented his/her calibre).
Whatarethestrengths/weaknessesoftheapplicant?
Any further relevant information.
- -
Name of applicant (block capitals or type)
Signed Date
To be completed by the referee.
Thisformmaybephotocopied:pleasetypeifpossible,orwriteinblackink.Pleaseaxanocialstamp,where
appropriate, at the end of the statement
Name of referee
Post/Occupation/Relationship
How long have you known applicant
Name of School/College/Organisation
Address
Postcode Country
Tel No. Fax No.
Email
In order to monitor equality of opportunity in the admission of students to the University of Northampton, applicants
areaskedtodescribetheirethnicorigininoneofthecategoriesbelow.Yourresponsewillnotinuencetheoutcome
of your application. You do not have to answer this question if you do not wish.
Equal opportunities monitoring form
A White
British 11
Irish 12
AnyotherWhitebackground,pleasedetail 19
B Mixed
WhiteandBlackCaribbean 41
WhiteandBlackAfrican 42
WhiteandAsian 43
AnyotherMixedbackground,pleasedetail 49
C Asian or Asian British
Indian 31
Pakistani 32
Bangladeshi 33
AnyotherAsianbackground,pleasedetail 39
F Information refused
98
B Black or Black British
Caribbean 21
African 22
AnyotherBlackbackground,pleasedetail 29
E Chinese or other ethnic group
Chinese 34
AnyotherChinesebackground,pleasedetail 80
I indicated on my application that I have a disability. Yes No
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Application Form Please complete the below form and (University of Northampton)

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Completed 4 February 2021

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