Application form

Please type or write clearly in block capitals in black ink. Tick boxes ❏ as appropriate.

1. Your personal details and contact details

Title (Mr, Miss, Mrs, Ms, Dr, Mx. etc)

Family name

First name(s)

Official name (as it appears on your passport/national identity card)

DD MM YY
Date of birth Previous family names
Address Home Correspondence (if different from home address)
Line 1
Line 2
Line 3
City
Postcode (UK only)
Country
Email @ @

Telephone numbers (please include full country and area code)

Area Code
Mobile Other

2. Details of your proposed programme of study

Taught courses only

Mode of study Full-time Part-time Distance learning
MM YY
Proposed start date

Award Undergraduate (eg BA, BSc) Postgraduate - not Research (eg MA, MSc, MBA)

Other Please specify

Course or module title

Year of entry ✔ 1 2 3

Research Programmes
Please refer to Additional information sheet for Research Applications.
3. Nationality and immigration

Country of birth (the country where you were born)

Nationality (which country issues your passport)

Country of domicile (the country where you are

permanently resident)

Do you require a visa to study in the UK? Yes No State type of visa (eg Student)

If no, do you already have a visa? Yes No

If you answer yes to the above question please attach a copy of your passport
If you answer no to the above question please go to section 4

Have you previously studied in the UK? Yes No

Are you currently in the UK? Yes No

DD MM YY
When did you first enter the UK?

If yes, what visa do you currently hold

Have you ever been refused a visa for entry into the UK Yes No If yes, please provide refusal documentation

Have you ever been refused entry into the UK Yes No If yes, please provide refusal documentation

Have you ever been subject to any notice, or removal

from the UK by the Home Office, due to overstaying Yes No If yes, please provide refusal documentation
leave to remain?

4. English language
Is your first language English? Yes No

If no, do you hold any English language qualifications? Yes No

Please attach copies of all English language certificates

Would you like to be considered for our Pre-sessional English for Academic Purposes course? Yes No

Applications for postgraduate courses and research degrees only

Was English the language of instruction for your first degree? Yes No

If yes please provide details of your previous study in section 6 of the application.

5. Financial information

How do you intend to pay for your tuition fees?

Personal/family resources Employer Sponsorship Scholarship Government body Research council

If you are not a self-funding applicant please give the name and address of your sponsor below and enclose a copy of your
letter confirming funding.

Name of sponsor
Address

Postcode
Country
Email address @
Area Code
Phone number
 6. Education
Your application will be considered on the basis of your education. You should therefore give full and accurate details of your education background in this section.
For your application to university, you must include details of all relevant qualifications in date order. (Most recent first)

QUALIFICATIONS
Examinations or assessments for which results are known (including those failed) and examinations or assessments to be completed, or results not yet published
Start date End date Awarding institution Award and course title Result Grade Language of
(DD MM YY) (DD MM YY) Mark or Band Instruction

Applications for nursing and education courses only

Nursing reference number

Teacher reference number

 7. Work experience
To support your application it is important that you provide details of any work experience you may have

Please give details of any work experience, showing your most recent first

Dates of employment Name and address of organisation Job title and brief summary of responsibilities/
achievements

From To
8. Further information in support of application
Taught course applicants – in this section please provide further information in support of your application. You should
include a personal statement explaining why you have chosen this course, how your previous education and experience
have prepared you for the course, and the impact it will have on your future career, if applicable ( maximum 500 words).

Research applicants – in this section please provide an outline of your proposed research programme. This should include
an outline of the research questions/area, aims of the project, methodology (if known), potential impact of the research and
some key background literature/references (maximum 1500 words).

Continue overleaf
Further information continued.

Please continue on a separate sheet if necessary

 Reference
It is your responsibility to request references from your referees, we will not do this on your behalf.
Please type or write clearly in block capitals in black ink. Tick boxes ❏ as appropriate.

The person named in Section 1 below has applied to study at Please tell us if you object to the reference being open to the
Sheffield Hallam University. They have selected you as their data subject on request. Please note that the University may
referee. Please complete and return this form to the address decide to disclose the reference without your consent, if it is
given in Section 5. able to anonymise the information (to protect your identity) or it
is considered reasonable to release the reference even though
A PDF version of this form can be downloaded at
it is possible to identify who wrote the reference. The University
www.shu.ac.uk/study-here/how-to-apply/postgraduate/
will balance the data subject’s right of access with your right of
application-form. References can be scanned and submitted
privacy.
by email providing that they are on the reference forms provided
or on official letter headed paper.
Referees should be aware that under the provisions of the
General Data Protection Regulation (GDPR) and the Data
Protection Act 2018 applicants may ask the University to
disclose references that have been used in the admissions
process. References will also be accessible if requested in
connection with legal proceedings.

Sections 1 and 2 must be completed by the applicant

1. Applicant’s full name

2. Course or Module title applied for

Section 3-5 to be completed by the referee

3. Referee’s details

Name
Position/role
Company/organisation
Address

Postcode
Country
Email address @
Area Code
Phone number
(including full country and area code)
4. Report on the applicant
MM YY
How long have you known the applicant?

In what capacity do you know the applicant?

In your opinion is the applicant likely to successfully No Uncertain/don’t know

Yes
complete and benefit from the programme of study
for which they are is applying?

Please specify the applicant’s general suitability to undertake the course(s) including distinct strengths and
areas for improvement

Please continue on a separate sheet if necessary

5. Referee’s declaration

I confirm that, to the best of my knowledge, the information given in this form is correct and complete

Referee’s signature

Print name

Date

What to do next
Please email completed reference to new-applications@shu.ac.uk, please type “reference” in the subject heading of the email
 Reference
It is your responsibility to request references from your referees, we will not do this on your behalf.
Please type or write clearly in block capitals in black ink. Tick boxes ❏ as appropriate.

The person named in Section 1 below has applied to study at Please tell us if you object to the reference being open to the
Sheffield Hallam University. They have selected you as their data subject on request. Please note that the University may
referee. Please complete and return this form to the address decide to disclose the reference without your consent, if it is
given in Section 5. able to anonymise the information (to protect your identity) or it
is considered reasonable to release the reference even though
A PDF version of this form can be downloaded at
it is possible to identify who wrote the reference. The University
www.shu.ac.uk/study-here/how-to-apply/postgraduate/
will balance the data subject’s right of access with your right of
application-form. References can be scanned and submitted
privacy.
by email providing that they are on the reference forms provided
or on official letter headed paper.
Referees should be aware that under the provisions of the
General Data Protection Regulation (GDPR) and the Data
Protection Act 2018 applicants may ask the University to
disclose references that have been used in the admissions
process. References will also be accessible if requested in
connection with legal proceedings.

Sections 1 and 2 must be completed by the applicant

1. Applicant’s full name

2. Course or Module title applied for

Section 3-5 to be completed by the referee

3. Referee’s details

Name
Position/role
Company/organisation
Address

Postcode
Country
Email address @
Area Code
Phone number
(including full country and area code)
4. Report on the applicant
MM YY
How long have you known the applicant?

In what capacity do you know the applicant?

In your opinion is the applicant likely to successfully No Uncertain/don’t know

Yes
complete and benefit from the programme of study
for which they are is applying?

Please specify the applicant’s general suitability to undertake the course(s) including distinct strengths and
areas for improvement

Please continue on a separate sheet if necessary

5. Referee’s declaration

I confirm that, to the best of my knowledge, the information given in this form is correct and complete

Referee’s signature

Print name

Date

What to do next
Please email completed reference to new-applications@shu.ac.uk, please type “reference” in the subject heading of the email
9. Data protection statement

All Applicants – Personal Data

Sheffield Hallam University is a registered data controller and will process your personal data in accordance with the General Data
Protection Regulation (GDPR), the Data Protection Act 2018 and other applicable legislation.
The University will use your personal data to process your application and for the purpose of making course offers and entering
into a student contract with you. You will receive communications from us that are necessary for the University to process your
application, make course offers and prepare for enrolment. The information from your application form will be used to set up
a student record on the University’s student information (SI) system. The University may contact other institutions to confirm
previous qualifications obtained. We may also invite you to provide feedback on your experiences to help us improve our
services.
Personal data is never sold to a third party. The University seeks to comply fully with data protection laws and ensures all our
contractors and suppliers also comply. For more information about how your personal data is used and who your data may
be shared with, please see our Privacy Notice for Student Applicants: www.shu.ac.uk/about-this-website/privacy-policy/
privacy-notices/privacy-notice-for-student-applicants
All Applicants – Marketing Options
From time to time the University would like to send you further information that we feel, based on your enquiry, will provide helpful
information and advice whilst you are considering applying to university. If you do not want to hear from us, you have the right to
object and can unsubscribe from contact by the channels listed below. If you don’t want to hear from us please tick all 5 boxes.

I do NOT wish to receive further information by

Post Text Phone Email Social Media

You can update these options and unsubscribe from mailings at any time by emailing askhallam@shu.ac.uk.
You will automatically be removed from our mailing list after 2 years.
International Applicants Only
In order to prevent and detect fraud and comply with regulations for international students we reserve the right to, or may
be required to, share this information with external organisations such as the police, the Home Office, the Foreign and
Commonwealth Office, the UK Visa’s and Immigration and local authorities. The University is required to check international
students’ eligibility to study in the UK. This may require the University to liaise with and exchange data with the Home Office or
related Government agencies in relation to students’ visa history and/or immigration history, during the admissions process.
 I consent to the Home Office, or related Government agency, releasing information about my immigration history to the
University for these purposes. This may include sensitive personal data about any orders, warnings, convictions or other
penalties relevant to immigration. (Please note that failure to provide consent by ticking the above box may delay the
processing of your application.)
If you have a query about how your data is used by the University, or would like to make a complaint about how the University
has used your personal data, please contact our Data Protection Officer: DPO@shu.ac.uk. For more information about your data
protection rights see: www.shu.ac.uk/about-this-website/privacy-policy/data-subject-rights

10. Declaration
Please read and then sign the declaration statement below:
Any offer of a place to study on a course at the University will be made subject to the University’s Terms and Conditions and Student
Regulations. It is therefore important that you read and understand the University’s Terms and Conditions and Regulations. These can
be accessed at www.shu.ac.uk/study-here/terms-and-conditions-and-student-regulations.
If you provide false, incomplete or misleading information to the University as part of this application, the University may withdraw any
offer of a place made to you. Full details of the University’s Admissions Regulations can also be accessed at
www.shu.ac.uk/study-here/terms-and-conditions-and-student-regulations.
If you have any queries about the University’s Terms and Conditions or the Student Regulations please contact us at
new-applications@shu.ac.uk before signing this application form.
I confirm that, to the best of my knowledge:
• the information I have given in this form is true, complete and accurate; and
• I have included all relevant information in this form.

Applicant’s Date
signature

What to do next
Please send your completed application form to new-applications@shu.ac.uk
11. Disabilities and support needs
If you declare a disability this will not be a factor in the university’s decision as to whether or not to offer you a place. However
it is important that the University knows if you have any specialist needs in order that we can provide you with appropriate
support and facilities.

This information will remain strictly confidential.

Do you consider yourself to have a disability Yes No Prefer not say

Type of disability
Specific learning disability e.g. dyslexia, dyspraxia etc. Blind/partially sighted
Deaf/hearing impairment Wheelchair user/mobility difficulty
Autistic spectrum disorder/Asperger’s syndrome Mental health difficulty
Multiple disabilities Personal care support

please specify
Unseen disability e.g. diabetes, cancer, epilepsy, asthma etc
please specify
Other

Nature of support required

12. Equal opportunities monitoring

Ethnic origin

White Asian or Asian British – Pakistan Mixed – white and Asian

Gypsy or traveller Asian or Asian British – Bangladesh Other mixed background
Black or black British – Caribbean Chinese Arab
Black or black British – African Other Asian background Other ethnic background
Other black background Mixed – white and black Caribbean Prefer not say
Asian or Asian British – Indian Mixed – white and black African

Religion

Bahá’í Faith Muslim No religion

Buddhist Sikh Pagan
Hindu Any other religion or belief Christian
Jewish Prefer not say Other

Gender

Male Female Other Prefer not say

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