Direct Undergraduate
Partner Application Form
This form is to be used by applicants who wish to apply for an undergraduate course at a Partner institution.
Please ensure all sections are fully completed.
1 Personal details
Have you previously studied at the University of Bedfordshire (or Luton/DMU Bedford)? YES/NO
If yes, please provide details of the course (title):
Former student reference number:
Title: Surname/family name (BLOCK CAPITALS):
First name(s):
Previous surname (if changed):
Gender: M/F Date of birth:
Correspondence address:
Contact telephone no.: Mobile telephone no.:
2 Fee status and additional supporting information
Please attach a copy of your current passport and, where applicable, any Home Office documents
Country of birth: Nationality (citizenship):
Country of permanent residence:
Applicants not born in the European Union please state
Date of first entry to the UK: Date of most recent entry to the UK:
Date from which you have been granted permanent residence in the UK:
Payment of fees
Who is expected to pay your fees? (Research Council, Local Education Authority, yourself, family member, employer, other):
Ethnic origin (please tick one):
White c Black Caribbean c Black African c Black other c Asian Indian c Asian Pakistani c
Asian Bangladeshi c Asian Chinese c Asian other c Mixed c Other c Prefer not to say c
3 Course
Course name:
Point of entry:
Start date:
4 Residential category
UK Citizen or EU National c Refugee c
EEA or Swiss National c Humanitarian Protection or similar c
Child of a Turkish worker c Settled in the UK c
5 Last two educational establishments attended
Give names and addresses of the last two educational establishments that you attended
Establishment Full or part-time From (mm/yy) To (mm/yy)
6 Qualifications
Please list results, and attach photocopies of your certificates or transcripts.
eg GCSE/Degree
Subject Date (mm/yyyy) Institution Result
7 Additional needs
You may use this section to provide a supporting statement or further details relating to your application and course
of study. You may prefer to attach a separate statement.
Please indicate if you have a disibility:
No disability c Autistic Spectrum c Visual Impairment c Hearing Impairment c Long-term Health c
Mental Health c Dyslexia c Wheelchair User c Other disability not listed c Multiple disabilities c
Please give further details of any support needs which might necessitate special arrangements or facilities:
8 Further information
9 Recruitment Agency Details
Recruitment Agency Name: Agent Code:
10 Data processing
The information you provide on the application form and any supporting evidence will be used by the University for the following purposes,
determine your eligibility for entry to the University of Bedfordshire
provide you with relevant information to assist you in joining the University (including information about open days, scholarships/
discounts and fees, enrolment at the University, your course, your faculty and the University’s facilities, the local area, accommodation
providers engaged through the University’s approved accommodation system, internships and career opportunities, visa advice and
travel advice)
enable the University of Bedfordshire to compile statistical reports
enable the University of Bedfordshire to initiate your student record
Information that you provide during the application process may be shared with:
relevant government departments and NHS bodies, including: Higher Education Statistical Agency, UK Visas and Immigration, Higher
Education Access Tracker (HEAT), Office for Fair Access and the Office for Students, Student Loan Company, Department for Education
and its agencies , Frontline (a Government funded body which commissions social work training), ESFA (for apprenticeships)
public sector regulatory bodies such as OFSTED and the Office for Standards in Education
NARIC (for the assessment of international qualifications)
UCAS (for undergraduate full-time provision)
bodies responsible for the professional accreditation of your course, if applicable
the Police or other authority in relation to crime prevention or investigation, or in association with the Government’s Prevent agenda
accommodation providers (where applicable) who are engaged through the University’s approved accommodation system: Liberty
Living and Student Village
John Smiths bookshop and Aspire Gym so that if you are eligible to receive a BedsMoney card, you can use it to purchase learning
materials or gym membership, respectively
any partner of the University which is delivering the programme or whose premises are used for the delivery of a programme for
which you have applied
your employer, if you are applying for an apprenticeship, in accordance with the contract between your employer and the University of
In the event that you do not register as a student of the University of Bedfordshire, the University will retain your personal information for
the rest of the academic year for which you have applied plus one further academic year in accordance with the University’s data retention
policy. In the event that you do register, your data will be managed as per the Student Privacy Policy which you will sign at registration.
Every effort is made to ensure that the information provided on the University’s website and elsewhere about the
programme for which you have applied in this application is accurate. However, it may become necessary for the university to
make changes, for example to programme content, course delivery and fees, due to legitimate staffing, financial regulatory
and academic reasons including (but not limited to) industrial action, lack of demand, departure of key personnel, change in
government policy, withdrawal or reduction of funding, the requirements of the quality code of the Quality Assurance Agency
or a change of law.
The University will endeavour at all times to keep such changes to a minimum and to keep students informed appropriately.
If a course is not provided in whole or in part, the university will take such steps as are available to it to minimise the effect of
any alteration or withdrawal. Such steps may include alterations to delivery of teaching or assessment, the offer of a place on
an alternative course or the offer to transfer to another course at the university or elsewhere.
You will be entitled to decline to accept the changes to the programme and withdraw but not to receive a refund for those
parts of the programme that you have completed whether or not you have passed any assessment.
Notes for guidance
Before completing the form, please ensure that you read
these notes carefully. You should also read the current
University of Bedfordshire literature relating to the course(s)
in which you are interested. The University’s regulations are
to be found at:
Students with Experience
The University of Bedfordshire welcomes applications from
students with experience, including those who do not have
conventional qualifications for admission to higher education
in the UK. Full account is taken of relevant experience and
other educational achievements.
Section 1 Personal details
Complete this section in BLOCK CAPITALS.
Section 2 Fee status
Please state your country of permanent residence and give
details of who you expect to pay your fees for the proposed
Section 6 Qualifications
Enter the exact subject name used by the examining body
and the name of the examining body in full. If you have
qualifications obtained outside the UK, you should give
details of all examinations taken as preparation for entry to
higher education (eg School and Higher School Certificate,
Apolytirion, Baccalaureat). Applicants with qualifications
obtained in a language other than English must attach a
certified English transcript to the form.
Section 7 Additional needs
Describe your condition and, where it is not obvious,
indicate whether you have special needs.
Please return the completed form to:
University of Bedfordshire
University Square
LU1 3JU - ENGLAND email:
11 Declaration and submission
I hereby certify that all of the above information is correct and complete, and that I wish to apply for admission as a student
of the University. I also declare that, if admitted, I shall conform to all the Rules and Regulations of the University of
Bedfordshire. I understand that the submission of any misleading information during the admission process could lead to the
immediate cancellation of my application and the withdrawal of any offer made. In the event that I register as a student of the
University of Bedfordshire, I hereby undertake to pay, as and when due, all University fees.
I grant permission to the University of Bedfordshire to verify my qualifications with the relevant exam board and/or institution
and/or NARIC, if necessary. I grant permission to the University of Bedfordshire to request information pertaining to my
current or previous visa status in the UK from the Home Office, if necessary. I grant permission for the University to contact
any referees nominated by me during the application process to request or verify a reference.
Signature: Date: