RPA 2022 Entry HE Application website.docx
- 1. Record of prior acceptance Student information (*Mandatory information) Title* First name* Make sure your name is as it appears on any official documents, such as your passport, birth certificate or driving licence. Lily Last name* If you don't have a last name, add your first name here again. Ajaib Gender* Please choose from male or female, selecting the gender you most identify with at this time. Female Date of birth* 23/05/2005 Address line 1* 3 Cranbrook Close, Wheldrake Address line 2 York Address line 3 Address line 4 Postcode (UK only) Non-UK postcodes should be entered on the last line of the address YO19 6BY Country of address* England Email address* lilyajaib@gmail.com Telephone number Fee payer* This is who will fund your studies. Circle or highlight the option that applies to you. Private finance | SLC,SAAS,NIBd,EU,Chl,IoM | Research Council | DH/Regional Health | UK Govt intl award | Training Agency | Other UK govt award | International agency; UK industry/commerce | Other source | Not Known Area of permanent residence* This is the area in which you normally live. If your permanent home is in the UK this is the county you live in. If you live outside the UK, tell us the country you live in. UK Residential category* Circle or highlight the option that applies to you. EEA or Swiss national | Child of a Turkish Worker | Refugee | Humanitarian Protection or similar | Settled in the UK | Other | UK Citizen – England | UK Citizen – Scotland | UK Citizen – Wales UK Citizen - Northern Ireland | British Citizen - Channel Islands and Isle of Man | British Citizen - British Overseas Territories | EU National (non-UK Citizen) Date of entry to the UK (for non-UK students) Course code* F3P6
- 2. Last updated: June 2021 Your chosen uni or college will be able to tell you this if you don’t know it. Campus code If there is no campus code, leave blank Point of entry* This is the year of the course you will start at. E.g. first year = 1, second year = 2, third year = 3. 1 Course start date* (Format of DD/MM/YYYY) Country of birth* England Nationality* British Disability* Circle or highlight the options that applies to you. No disability | Autistic disorder | Blind/partial sight | Deaf/partial hearing | Long standing illness | Mental health | Learning difficulty | Wheelchair/mobility | Other disability | Multiple disabilities Ethnicity* Circle or highlight the option that applies to you. White | Gypsy, Traveller or Irish Traveller | Black – Caribbean | Black – African | Black – Other | Asian – Indian | Asian – Pakistani | Asian – Bangladeshi | Asian – Chinese | Asian – Other | White/Black Caribbean | White/Black African | White and Asian | Other Mixed | Arab | Other Declaration I confirm that the information given on this form is true, complete and accSurate and no information or other material information has been omitted. I accept that if this is not the case, UCAS shall have the right to cancel my application and I shall have no claim against UCAS or any other higher education institution or college in relation thereto. I also accept that, having completed and signed the form, I do not have the right to further choices within the UCAS scheme and will not approach any other university or college in the UCAS scheme. You have the right to cancel this application. If you decide not to take up your place at the university or college you must do this by informing the university or college who have offered you the place as soon as possible. Student’s signature: Date: This form is for institution information only - please do not send to UCAS.