2014-15 Application Form International student Please complete in block capitals using a black ink pen. Personal Details Surname
First name
Address
Post code Home telephone
Mobile
Date of Birth (dd/mm/yy):
Sex: Male
Female
Country of residence:
Nationality:
Have you been resident in the European Economic Area for the past 3 years? Yes
No
Do you have a restriction on your passport? Yes
Please specify:
No
Equal Opportunities Monitoring Ethnicity (please tick which description you feel best describes you) Asian or Asian British – Bangladeshi Asian or Asian British – Indian Asian or Asian British – Pakistan Asian or Asian British – any other Asian background Black or Black British – African Black or Black British – Caribbean Black or Black British – any other Black background Chinese Mixed – White and Asian Mixed – White and Black African Mixed – White and Black Caribbean Mixed – any other Mixed background