Fillable Application form Notes for guidance (University of Hertfordshire)

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Application form Notes for guidance (University of Hertfordshire)

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General
Before completing the form, please read these notes carefully. You
should also consult the specific course pages on the University’s
website (www.herts.ac.uk) to ensure that you are familiar with the
course structure and entry requirements. Your application form may be
photocopied, therefore it is important that you write neatly using black
ink or typescript. Many courses have a deadline by which applications
should be received. Please consult course literature or the department
concerned.
Mature Applicants
The University of Hertfordshire (UH) welcomes mature students,
including those who do not have conventional qualifications, for
admission to higher education. Full account is taken of relevant
experience and other educational achievements. All applicants must
hold GCSE English Language and Mathematics at grade C or above.
GCSE Science may also be required for certain courses. Please check
the specific course pages for more details. The University accepts
certain GCSE equivalences as listed on our website:
http://www.herts.ac.uk/courses/entry-requirements/undergraduate-
degrees/gcse-equivalent-entry-requirements.cfm
The Data Protection Act 1998
In completing and submitting your application form, you will be
providing the University of Hertfordshire with personal data, including in
some cases sensitive personal data, as defined in the Data Protection
Act 1998. The University will use this data for the purposes of
processing your application and for other administrative purposes
relating to your application. The University will process this data in
accordance with the provisions of the Data Protection Act 1998 and
with its own policies on data protection (which can be found on its
main Data Protection web page at http://www.herts.ac.uk/about-
us/freedom-of-information-data-protection/data-protection.cfm and in
the other documents and web pages which are referred to on, and
linked to from, this main web page). 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, qualifications,
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. Some of these third parties
may be located outside the UK (including outside the European
Economic Area). By submitting your application, you will be deemed
to be giving your consent to the processing and use of your personal
data as set out in this paragraph.
Referees
Send part B, “The Reference”, to your referees, having completed the
personal details on the first side. It is your responsibility to ensure that
UH receives your references.
Section 3 Finance and Fee status
If you live in the UK, state your area of permanent residence. This
might be district (Sefton), borough, (Enfield), metropolitan area (Gt
Manchester), or county (Hertfordshire). If you live outside the UK state
the country (Italy, France etc) where you are living as your area of
permanent residence. Please give details of who you expect to pay
your fees for the proposed course. If not known, please indicate this.
Section 7 Academic Qualifications achieved
Applicants with overseas qualifications should give details of the
examinations taken as preparation for entry to higher education, for
example Higher School Certificates, Apolytirion, Baccalaureate,
Diploma di Maturita, Examen Artium and Studentereksamen.
Applicants with qualifications obtained in a language other than English
should attach a certified English transcript to the form. Applicants
holding a BTEC award such as an Extended Diploma, NVQ (SVQ), or
Access to HE Diploma should attach a certificate of achievement/unit
credit giving details of the award title, level if applicable, and all
units,modules and components.
Section 8 Academic Qualifications pending
If you are working towards an award, NVQ (SVQ) or GNVQ (GSVQ)
please give full details of course title, level, units, modules and
components on a separate sheet.
Section 11 Personal statement/further information
Enter information to support your application. Admissions Tutors will
be interested in your reasons for choosing the course(s), your career
aspirations, relevant experience and information concerning your
intellectual, social, sporting or other interests. You should give details
of any non-examined subjects you are studying. If you have been out
of education, please outline any relevant experience that may be
considered in lieu of formal qualifications, either at home or in voluntary
or paid work. You should explain any gaps or breaks in your career. If
you are applying for deferred entry (a year beyond the next academic
year) please explain your reasons.
Section 12 References
Please consult the University’s website to see if any particular type or
number of referees is required (you should send Part B to both your
named referees). Some departments may contact referees directly
after receipt of your form. Normally your referees should be: the Head
of your present or last school; Principal of your College of Further
Education; Course Tutor or your present or last course of studies. If
you have been out of education for some time you may wish to
consider the following: your current or last employer, or training officer,
or careers advisor; if you belong to a relevant organisation, voluntary or
not, an officer of that organisation; Access course tutor. If you have
any difficulty in identifying suitable referees you should seek the advice
of the University Admissions Service.
Section 13 Disabilities/Special Needs
(Physical or other disability or medical condition including any which
might necessitate special arrangements or facilities) Information on
disability will be shared with the University's Disability Services. Unless
special needs are made known, the University will be unable to make
appropriate provision for you.
Important Note
The University uses all reasonable endeavours to provide its
educational and other services to students in the manner set out in its
prospectus and in its other relevant published materials. Should
industrial action or other circumstances beyond the University of
Hertfordshire’s reasonable control interfere with its ability to provide
these services, the University will use all reasonable endeavours to
minimise any disruption caused to students. The University reserves
the right to make changes to the content or methods of delivery of
courses and modules, and to discontinue or merge courses or
modules, in whole or in part, where the University reasonably believes
that this is in the interests of the University or of students. In these
circumstances, the University will notify affected students as soon as
reasonably practicable and, in the case of a discontinued course or
module, will where appropriate use all reasonable endeavours to offer
the students a suitable alternative course or module. The University of
Hertfordshire does not therefore accept any absolute obligation to
provide its educational or other services in the manner set out in its
prospectus or elsewhere, nor does it accept any other obligation in
respect of the provision of educational or other services which is more
onerous than the obligations set out in this paragraph.
Any offer of a place made to you by the University of Hertfordshire will
be made on the basis that, on registration, you will confirm your
agreement to certain terms and conditions that will apply to you as a
student at the University, including the provisions of the preceding
paragraph and your agreement to comply with and be bound by the
University’s institutional policies, procedures and regulations (UPRs) in
force from time to time, the current version of which can be found at
www.herts.ac.uk/upr
Application form – Notes for guidance
Application form Please print clearly in black ink and BLOCK CAPITALS
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
Home/permanent address Correspondence address (if different)
Postcode Postcode
Country Country
Tel No Tel No
Mobile Mobile
Email Email
2 Course(s) applied for
First choice Associate College Campus
(if applicable)
Point of entry Nursing Branch
(i.e. year 1,2 or 3)
(If applying for nursing, please state preferred branch)
Mode of study Full-time Part-time Distance
Level of study Undergraduate Postgraduate (taught) Research
Starting date Month Year
Second choice Associate College Campus
(if applicable)
Year of entry Nursing Branch
(If applying for nursing, please state preferred branch)
Mode of study Full-time Part-time Distance
Level of study Undergraduate Postgraduate (taught) Research
Starting date Month Year
dd mm yy
3
Finance and fee status
All students offered registration will be asked to supply details of their financial position, letters of guarantee from sponsors etc,
to ensure that they can complete the course without financial hardship.
W
ho will be paying your fees?
Self Socrates / Erasmus / Franchise Career Development Loan
NHS
SLC
Employer Please give details
Other Please give details
Nationality (if dual please give both) Country of birth
Country of permanent residence (if UK, give County/Borough) Entry date to UK
- -
Please give details of any scholarship grant application giving name, value and duration
Already awarded Please give details
Application made Please give details
4 Declaration of a criminal conviction
To help the University reduce the risk of harm or injury to their students caused by the criminal behaviour of other students, we must
know about any relevant criminal convictions that an applicant has.
Relevant criminal convictions are only those convictions for offences against the person, whether of a violent or a sexual nature, and
convictions for offences involving unlawfully supplying controlled drugs or substances where the conviction concerns commercial drug
dealing or trafficking. Convictions that are spent (as defined by the Rehabilitation of Offenders Act 1974) are not considered to be
relevant and you should not reveal them (but see next paragraph).
If you are applying for courses in teaching, health, social work and courses involving work with children or vulnerable
adults, you must tell us about any criminal convictions including spent sentences and cautions (including verbal cautions)
and bind-over orders. If you are offered a place on one of these courses, and before you commence your studies, you will
need an ‘Enhanced Disclosure Document’ from the Criminal Records Bureau. The University will provide you with the
information on how to do this.
Courses in teaching, health, social work and courses
involving work with children or vulnerable adults.
For these courses, you must answer ‘Yes’ if any of the
following statements apply to you.
a) I have a criminal conviction.
b) I have a spent criminal conviction.
c) I have a caution (including a verbal caution).
d) I have a bind-over order.
e) I am serving a prison sentence for a criminal conviction.
If statement e) applies to you, you must also give the prison
address as your postal address on page 1 of your application
and a senior prison officer must support your application.
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 final decision.
If you are convicted of a relevant criminal offence after you have applied, you must tell us. Do not send details of the offence;
simply tell us that you have a relevant criminal conviction. The University may then ask you for more details.
All other courses
For those course, you must answer ‘Yes’ if any of the
following statements apply to you.
a) I have a relevant criminal conviction that is not spent.
b) I am serving a prison sentence for a relevant criminal
conviction.
If statement b) applies to you, you must also give the
prison address as your postal address on page 1 of your
application and a senior prison officer must support your
application. Convictions that are spent (as defined by the
Rehabilitation of Offenders Act 1974) are not considered to
be relevant and you should not reveal them.
dd mm y y yy
5
Previous study in the UK (for overseas applicants)
The Home Office 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:
H
ave 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.
Institution Course studies and level Start and completion Type of visa held during
i.e. foundation/degree etc of course period of study
If you have been a student at the University of Hertfordshire or one of its associate colleges before, 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
6 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/SW/DL*
*PT = part-time, FT = full-time, SW = sandwich, DL = distance learning
7 Academic qualifications – examinations achieved
Please list all qualifications taken, whatever the result, in chronological order. Documentary evidence of known results should be sent
with this form. Only certified photocopies are acceptable.
Exam Date (mm/yy) Awarding body Subject Qualification Results achieved
8 Academic qualifications – examinations pending
Complete this section only if you are awaiting the result of any examination taken recently.
Exam Date (mm/yy) Awarding body Subject Qualification
9 English language (for overseas applicants)
Entry is conditional on the attainment of the required proficiency in the English Language (see website: www.herts.ac.uk).
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
10 Work experience (if applicable to course application)
Please give details of work experience, training and employment.
Dates from Dates to FT/PT* Post held Organisation name and address Brief description of duties
(mm/yy) (mm/yy)
*FT = full-time, PT = part-time
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.
1
2 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.
Referee 1 Referee 2
Name Name
A
ddress Address
Postcode Postcode
Tel Tel
Fax Fax
E
mail 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 the University’s Disability Services department 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 Statement on Disability Disclosure by Students. You can access this and find information
about Disability Services at UH at www.go.herts.ac.uk/disability
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 difficulties
disabling medical conditions
Other disability not listed above
Specific Learning Difficulty
(eg Dyslexia)
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
Declaration
I confirm that the information given on this form is true, complete and accurate and no information requested or other material
information has been omitted.
Signed Date
Please return completed applications to:
The University Admissions Service, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB
Mature applicants
Referees may have difficulty in commenting on the academic
abilities of mature applicants who may not have any recent
educational experience, and in these circumstances, referees
may wish to confine their comments to matters listed under
1, 2c, 3, 4, 5 and 6 opposite.
Despatch arrangements
Having supplied the reference, please return it to the applicant.
Seal the envelope, sign across the seal and cover your
signature with clear tape before returning it to the applicant
Part B – Statement by referee
To be completed by applicant
Applicant's full name
Course
(
see website for title: www.herts.ac.uk)
Date of Birth
-
-
Male Female
Name and address to which reference is to be sent
(
ie your address)
Postcode Country
Email address
Notes for the guidance of referees
The referee's report is an integral and important part of
the selection process, and the information you give will help
to guide admissions tutors in making their decisions.
When you write personal comments about an applicant,
please remember that under the Data Protection Act,
the applicant can ask for a copy of the reference and any
other personal information that we have about them.
Depending on the circumstances, we may therefore decide
that we have to disclose the reference, in part or in whole,
to the applicant, even if you have marked it as confidential.
In order that the University can evaluate an applicant's
academic and intellectual capacity, your reference should
if possible cover:
1 Suitability for the course(s) applied for
2 Intellectual qualities including:
(a) development to date and previous examination
performance with special reference
to any factors which may in your opinion have
adversely influenced the result;
(b) present performance;
(c) potential, including an assessment of the
probable results of any pending examinations.
3 Personal qualities
4 Career aspirations
5 Health and other personal circumstances relevant
to the application
6 Athletic, social and other interests
d
dmm yyyy
T
o be completed by the referee
This form may be photocopied: please type if possible, or write in black ink. Please affix official stamp, where appropriate, at the end
of the statement.
N
ame of referee
Post/Occupation/Relationship
How long have you known applicant
Name of School/College/Organisation
Address
Postcode Country
Telephone No Fax No
Email address
Name of applicant
(
block capitals or type)
Signed Date
Mature applicants
Referees may have difficulty in commenting on the academic
abilities of mature applicants who may not have any recent
educational experience, and in these circumstances, referees
may wish to confine their comments to matters listed under
1, 2c, 3, 4, 5 and 6 opposite.
Despatch arrangements
Having supplied the reference, please return it to the applicant.
Seal the envelope, sign across the seal and cover your
signature with clear tape before returning it to the applicant
Part B – Statement by referee
To be completed by applicant
Applicant's full name
Course
(
see website for title: www.herts.ac.uk)
Date of Birth
-
-
Male Female
Name and address to which reference is to be sent
(
ie your address)
Postcode Country
Email address
Notes for the guidance of referees
The referee's report is an integral and important part of
the selection process, and the information you give will help
to guide admissions tutors in making their decisions.
When you write personal comments about an applicant,
please remember that under the Data Protection Act,
the applicant can ask for a copy of the reference and any
other personal information that we have about them.
Depending on the circumstances, we may therefore decide
that we have to disclose the reference, in part or in whole,
to the applicant, even if you have marked it as confidential.
In order that the University can evaluate an applicant's
academic and intellectual capacity, your reference should
if possible cover:
1 Suitability for the course(s) applied for
2 Intellectual qualities including:
(a) development to date and previous examination
performance with special reference
to any factors which may in your opinion have
adversely influenced the result;
(b) present performance;
(c) potential, including an assessment of the
probable results of any pending examinations.
3 Personal qualities
4 Career aspirations
5 Health and other personal circumstances relevant
to the application
6 Athletic, social and other interests
dd mm y y y y
T
o be completed by the referee
This form may be photocopied: please type if possible, or write in black ink. Please affix official stamp, where appropriate, at the end
of the statement.
N
ame of referee
Post/Occupation/Relationship
How long have you known applicant
Name of School/College/Organisation
Address
Postcode Country
Telephone No Fax No
Email address
Name of applicant
(
block capitals or type)
Signed Date
Equal opportunities monitoring form
In completing this form you are helping the University to monitor the fairness of its admissions processes and to ensure equal
t
reatment for all applicants. This form will be separated from your application and will not be available to the Admissions Tutor.
The information supplied will be recorded on our computer system during the application process and the form will be
destroyed as confidential waste. Please tick the box/boxes that best describe you.
A White D Mixed
British 11 White and Black Caribbean 41
I
rish 12 White and Black African 42
Any other White background, please detail 19 White and Asian 43
Any other Mixed background, please detail 49
B Black or Black British E Chinese or other ethnic group
Caribbean 21 Chinese 34
African 22 Any other Chinese background, please detail 80
Any other Black background, please detail 29
C Asian or Asian British F Information refused
Indian 31 98
Pakistani 32
Bangladeshi 33
Any other Asian background, please detail 39
I indicated on my application that I have a disability Yes No
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Application form Notes for guidance (University of Hertfordshire)

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