1. Course Details
Course Title:
Proposed start date: Full-time Part-time
Proposed Year/Level of Entry: Year 1 Year 2 Year 3
2. Personal Details
FOR UNIVERSITY USE ONLY
SITS Applicant No. SITS AoS Code:
Decision Interview Date:
Reject Conditions of offer:
Offer
Signed: (Admissions Tutor/Course Director)
Please return to:
Birmingham City University,
Admissions,
University House,
15 Bartholomew Row,
Birmingham,
B5 JU
This form requests a significant amount of personal information. This is required so that we can decide on your suitability for the course you are
applying for. The information you provide will be used for this purpose and monitoring of equal opportunities only. It will be treated in confidence and
will only be seen by those whose jobs require them to do so.
APPLICATION FORM
Please complete in BLOCK CAPITALS
Title: Mr/Ms/Miss/Mrs etc. Gender: Male Female Other Date of birth:
First name(s):
Maiden or any other name(s) that you have been known by:
Surname/family name:
Permanent address:
Country: Postcode:
Correspondence address (if different):
Country: Postcode:
Daytime telephone: Evening telephone (if different): Mobile:
Email address: Nationality:
If not born in the UK please state date of arrival to UK: Area of permanent residence:
If you are a member of a Professional Body, please give its name and your Registration Number:
Have you ever studied in the UK before? (If yes, please include a copy of all visas)
What level was your previous study in the UK (please tick all that apply)?
Have you ever studied at Birmingham City University before?
Yes
Yes
No
No
Master’sFoundation Degree
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