University of Exeter Request For Representation Form

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Request for Representation

To be completed by the applicant, not by the agent/representative. Please read this form carefully before completing and signing it.

Applicant - Full Name: Mr/Mrs/Ms/Miss Miss AYDA SELEN BOZKURT


Course(s) applied for: Computer Science I400

Date of birth (DD/MM/YYYY) 12/05/2003 Gender Male / Female / Prefer not to say
FEMALE
Your Exeter ID No: 1598114263
(or UCAS n º)

I would like to be represented in the admissions process by this agency/representative:

AGENCY / REPRESENTATIVE NAME: ATEC YURTDISI EGITIM DANISMANLIGI – ANKARA OFFICE

I am aware of UK data protection legislation. I have read the guidance available at https://ico.org.uk/your-data-matters/. I consent to the
above-named agency/representative sharing my personal data with the University of Exeter in support of my application. I also consent to
the University of Exeter sharing my personal data, application and registration status with this agency/representative. I have read and
understood the University of Exeter’s terms and conditions:

Applicants for undergraduate courses: http://www.exeter.ac.uk/undergraduate/applications/terms/


Applicants for postgraduate courses: https://www.exeter.ac.uk/postgraduate/apply/terms/

My application was originally:

□ Submitted by me on DATE: 20 / 01 /2022 □ online □ by post


□ by hand □ via UCAS

√ Submitted by this agent on my behalf: AGENCY NAME: ATEC YURTDISI EGITIM DANISMANLIGI – ANKARA OFFICE

Whilst we strongly discourage applicants from changing their agent / representative after an application has been submitted, if you
are requesting this, please state your reasons for doing so.

Leave this space blank if not applicable.

SIGNED: (APPLICANT)
Note: this must be an ink
signature
DATE:
21/01/2022
BLOCK PRINT
or TYPE name clearly: AYDA SELEN BOZKURT

Note to agents – submission of this form does not automatically entitle you to commission.

For Office Use Only


ISR Approved Date: Decision: Y / N / HH

Entered in SITS Initial Date: Agent informed (date)

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