Application form – Notes for guidance
General Section 8 Academic Qualifications pending
Before completing the form, please read these notes carefully. You If you are working towards an award, NVQ (SVQ) or GNVQ (GSVQ)
should also consult the specific course pages on the University’s please give full details of course title, level, units, modules and
website ([Link]) to ensure that you are familiar with the components on a separate sheet.
course structure and entry requirements. Your application form may be
photocopied, therefore it is important that you write neatly using black Section 11 Personal statement/further information
ink or typescript. Many courses have a deadline by which applications Enter information to support your application. Admissions Tutors will
should be received. Please consult course literature or the department be interested in your reasons for choosing the course(s), your career
concerned. aspirations, relevant experience and information concerning your
intellectual, social, sporting or other interests. You should give details
Mature Applicants of any non-examined subjects you are studying. If you have been out
The University of Hertfordshire (UH) welcomes mature students, of education, please outline any relevant experience that may be
including those who do not have conventional qualifications, for considered in lieu of formal qualifications, either at home or in voluntary
admission to higher education. Full account is taken of relevant or paid work. You should explain any gaps or breaks in your career. If
experience and other educational achievements. All applicants must you are applying for deferred entry (a year beyond the next academic
hold GCSE English Language and Mathematics at grade C or above. year) please explain your reasons.
GCSE Science may also be required for certain courses. Please check
the specific course pages for more details. The University accepts Section 12 References
certain GCSE equivalences as listed on our website: Please consult the University’s website to see if any particular type or
[Link] number of referees is required (you should send Part B to both your
degrees/[Link] named referees). Some departments may contact referees directly
after receipt of your form. Normally your referees should be: the Head
The UK General Data Protection Regulation (UK GDPR) and of your present or last school; Principal of your College of Further
Data Protection Act 2018 (DPA) Education; Course Tutor or your present or last course of studies. If
In completing and submitting your application form, you will be you have been out of education for some time you may wish to
providing the University of Hertfordshire with personal data, including in consider the following: your current or last employer, or training officer,
some cases special category personal data, as defined in the UK or careers advisor; if you belong to a relevant organisation, voluntary or
General Data Protection Regulation (UK GDPR) and Data Protection not, an officer of that organisation; Access course tutor. If you have
Act 2018 (DPA) (“the legislation”). The University will use this data for any difficulty in identifying suitable referees you should seek the advice
the purposes of processing your application and for other of the University Admissions Service.
administrative purposes relating to your application. The University will
process this data in accordance with the provisions of the legislation Section 13 Disabilities/Special Needs
and with its own policies on data protection (which can be found on its (Physical or other disability or medical condition including any which
main Data Protection web page at [Link] might necessitate special arrangements or facilities) Information on
legal/freedom-of-information-data-protection/data-protection and in disability will be shared with the University's Disability Services. Unless
the other documents and web pages which are referred to on, and special needs are made known, the University will be unable to make
linked to from, this main web page). This personal data may also be appropriate provision for you.
shared with and used by third parties in connection with the above
purposes, for example, in order to verify your identity, qualifications, Important Note
work experience and other information that you provide, or so that the The University uses all reasonable endeavours to provide its
University can comply with its legal obligations to supply certain educational and other services to students in the manner set out in its
information to the Higher Education Statistics Agency. Some of these prospectus and in its other relevant published materials. Should
third parties may be located outside the UK (including outside the industrial action or other circumstances beyond the University of
European Economic Area). Hertfordshire’s reasonable control interfere with its ability to provide
these services, the University will use all reasonable endeavours to
Referees minimise any disruption caused to students. The University reserves
Send part B, “The Reference”, to your referees, having completed the the right to make changes to the content or methods of delivery of
personal details on the first side. It is your responsibility to ensure that courses and modules, and to discontinue or merge courses or
UH receives your references. modules, in whole or in part, where the University reasonably believes
that this is in the interests of the University or of students. In these
Section 3 Finance and Fee status circumstances, the University will notify affected students as soon as
If you live in the UK, state your area of permanent residence. This might reasonably practicable and, in the case of a discontinued course or
be district (Sefton), borough, (Enfield), metropolitan area (Gt module, will where appropriate use all reasonable endeavours to offer
Manchester), or county (Hertfordshire). If you live outside the UK state the students a suitable alternative course or module. The University of
the country (Italy, France etc) where you are living as your area of Hertfordshire does not therefore accept any absolute obligation to
permanent residence. Please give details of who you expect to pay provide its educational or other services in the manner set out in its
your fees for the proposed course. If not known, please indicate this. prospectus or elsewhere, nor does it accept any other obligation in
respect of the provision of educational or other services which is more
Section 7 Academic Qualifications achieved onerous than the obligations set out in this paragraph.
Applicants with overseas qualifications should give details of the Any offer of a place made to you by the University of Hertfordshire will
examinations taken as preparation for entry to higher education, for be made on the basis that, on registration, you will confirm your
example Higher School Certificates, Apolytirion, Baccalaureate, agreement to certain terms and conditions that will apply to you as a
Diploma di Maturita, Examen Artium and Studentereksamen. student at the University, including the provisions of the preceding
Applicants with qualifications obtained in a language other than English paragraph and your agreement to comply with and be bound by the
should attach a certified English transcript to the form. Applicants University’s institutional policies, procedures and regulations (UPRs) in
holding a BTEC award such as an Extended Diploma, NVQ (SVQ), or force from time to time, the current version of which can be found at
Access to HE Diploma should attach a certificate of achievement/unit [Link]/upr
credit giving details of the award title, level if applicable, and all
units,modules and components.
Application form Please print clearly in black ink and BLOCK CAPITALS
1 Personal details
Family name as appears in passport
First name(s) as appears in passport
Title (Mr/Mrs/Miss/etc) Previous family name (if applicable)
Date of Birth d d - m m - y y Male Female
Home/permanent address Correspondence address (if different)
Postcode Postcode
Country Country
Tel No Tel No
Mobile Mobile
Email Email
2 Course(s) applied for
First choice Associate College Campus
(if applicable)
Point of entry Nursing Branch
(i.e. year 1,2 or 3) (If applying for nursing, please state preferred branch)
Mode of study Full-time Part-time Distance
Level of study Undergraduate Postgraduate (taught) Research
Starting date Month Year
Second choice Associate College Campus
(if applicable)
Year of entry Nursing Branch
(If applying for nursing, please state preferred branch)
Mode of study Full-time Part-time Distance
Level of study Undergraduate Postgraduate (taught) Research
Starting date Month Year
3 Finance and fee status
All students offered registration will be asked to supply details of their financial position, letters of guarantee from sponsors etc,
to ensure that they can complete the course without financial hardship.
Who will be paying your fees?
Self Socrates / Erasmus / Franchise Career Development Loan
NHS
SLC
Employer Please give details
Other Please give details
Nationality (if dual please give both) Country of birth
Country of permanent residence (if UK, give County/Borough) Entry date to UK
d d - m m - y y y y
Please give details of any scholarship grant application giving name, value and duration
Already awarded Please give details
Application made Please give details
4 Declaration of a criminal conviction
To help the University reduce the risk of harm or injury to their students caused by the criminal behaviour of other students, we must
know about any relevant criminal convictions that an applicant has.
Relevant criminal convictions are only those convictions for offences against the person, whether of a violent or a sexual nature, and
convictions for offences involving unlawfully supplying controlled drugs or substances where the conviction concerns commercial drug
dealing or trafficking. Convictions that are spent (as defined by the Rehabilitation of Offenders Act 1974) are not considered to be
relevant and you should not reveal them (but see next paragraph).
If you are applying for courses in teaching, health, social work and courses involving work with children or vulnerable
adults, you must tell us about any criminal convictions including spent sentences and cautions (including verbal cautions)
and bind-over orders. If you are offered a place on one of these courses, and before you commence your studies, you will
need an ‘Enhanced Disclosure Document’ from the Criminal Records Bureau. The University will provide you with the
information on how to do this.
Courses in teaching, health, social work and courses All other courses
involving work with children or vulnerable adults. For those course, you must answer ‘Yes’ if any of the
For these courses, you must answer ‘Yes’ if any of the following statements apply to you.
following statements apply to you.
a) I have a relevant criminal conviction that is not spent.
a) I have a criminal conviction. b) I am serving a prison sentence for a relevant criminal
b) I have a spent criminal conviction. conviction.
c) I have a caution (including a verbal caution).
d) I have a bind-over order. If statement b) applies to you, you must also give the
e) I am serving a prison sentence for a criminal conviction. prison address as your postal address on page 1 of your
application and a senior prison officer must support your
If statement e) applies to you, you must also give the prison application. Convictions that are spent (as defined by the
address as your postal address on page 1 of your application Rehabilitation of Offenders Act 1974) are not considered to
and a senior prison officer must support your application. be relevant and you should not reveal them.
Please indicate if you have a relevant criminal conviction by ticking in the box Yes No
Applicants who answer ‘Yes’ will not be automatically excluded from the application process, and their application will be considered on
its merits before the relevance of their criminal conviction is taken into account. However, the University may ask for more information
about their criminal conviction before making a final decision.
If you are convicted of a relevant criminal offence after you have applied, you must tell us. Do not send details of the offence;
simply tell us that you have a relevant criminal conviction. The University may then ask you for more details.
5 Previous study in the UK (for overseas applicants)
The Home Office has introduced a limit to the time that international students on a Tier 4 Student Visa can spend studying at degree
level. There will be a general limit of 5 years on study time but this will not apply to those studying for Master’s degrees following
successful completion of an undergraduate degree where the undergraduate course duration was 4 or 5 years. In these cases the limit
will be set at 6 years. We also have to ensure that any study you are proposing to undertake represents academic progression from any
previous studies in the UK.
In view of this new policy it is essential that you answer the following question:
Have you ever studied previously in the UK? Yes No
If yes, please list below any previous study (regardless of the level i.e. English language courses) undertaken in the UK. We will also
require copies of all visas held during those periods of study.
Institution Course studies and level Start and completion Type of visa held during
i.e. foundation/degree etc of course period of study
If you have been a student at the University of Hertfordshire or one of its associate colleges before, please give your student ID number.
Do you require a Tier 4 visa to study with us? Yes No
If no please provide us with a copy of your current visa
6 Previous and present education
Please list details of all institutions attended since age 11.
Name and address of institution From (mm/yy) To (mm/yy) Study mode PT/FT/SW/DL*
*PT = part-time, FT = full-time, SW = sandwich, DL = distance learning
7 Academic qualifications – examinations achieved
Please list all qualifications taken, whatever the result, in chronological order. Documentary evidence of known results should be sent
with this form. Only certified photocopies are acceptable.
Exam Date (mm/yy) Awarding body Subject Qualification Results achieved
8 Academic qualifications – examinations pending
Complete this section only if you are awaiting the result of any examination taken recently.
Exam Date (mm/yy) Awarding body Subject Qualification
9 English language (for overseas applicants)
Entry is conditional on the attainment of the required proficiency in the English Language (see website: [Link]).
Please give full details, including dates, of any English tests taken/to be taken:
Level Where studied University/College/Awarding Body Date taken (mm/yy) Results
10 Work experience (if applicable to course application)
Please give details of work experience, training and employment.
Dates from Dates to FT/PT* Post held Organisation name and address Brief description of duties
(mm/yy) (mm/yy)
*FT = full-time, PT = part-time
11 Personal statement/further information
Please use this section to tell us about yourself and your reasons for wanting to study this course. Please continue on a separate
sheet if necessary.
12 References
Please read the guidance notes carefully. Please note that it is your responsibility to send Part B – Statement by Referee - to your
referees for completion. We will not be able to make a decision about your application until we receive your references.
Referee 1 Referee 2
Name Name
Address Address
Postcode Postcode
Tel Tel
Fax Fax
Email Email
Capacity in which applicant is known to the referee Capacity in which applicant is known to the referee
For how long For how long
Please note, references should not be provided by close family members or friends
13 Disabilities/special needs
Please tick the appropriate box(es) and in the space at the bottom of this section indicate any additional support or facilities
that you may need at the University. This information will be made available to the University’s Disability Services department who can
support applicants through the admissions process and agree adjustments for their studies. Information you disclose about your disability
will be used in accordance with the University’s Statement on Disability Disclosure by Students. You can access this and find information
about Disability Services at UH at [Link]/disability
No known disability Autistic Spectrum Disorder/Asperger’s Syndrome
Blind or a serious visual impairment Long standing illness or health condition
Deaf or a serious hearing impairment Mental health condition
Two or more impairments and/or Wheelchair user/mobility difficulties
disabling medical conditions
Other disability not listed above
Specific Learning Difficulty
(eg Dyslexia)
I am in receipt of the Disabled Students’ Allowance Yes No
I am applying for or intend to apply for the Disabled Students’ Allowance Yes No
Please detail below any additional support, adjustments or changes you may need for your studies
Declaration
I confirm that the information given on this form is true, complete and accurate and no information requested or other material
information has been omitted.
Signed Date
Please return completed applications to:
The University Admissions Service, University of Hertfordshire, College Lane, Hatfield, Hertfordshire, AL10 9AB
Part B – Statement by referee
To be completed by applicant
Applicant's full name
Course (see website for title: [Link])
Date of Birth d d - m m - y y y y Male Female
Name and address to which reference is to be sent (ie your address)
Postcode Country
Email address
Notes for the guidance of referees
The referee's report is an integral and important part of the Mature applicants
selection process, and the information you give will help to Referees may have difficulty in commenting on the academic
guide admissions tutors in making their decisions. abilities of mature applicants who may not have any recent
educational experience, and in these circumstances, referees
In order that the University can evaluate an applicant's may wish to confine their comments to matters listed under
academic and intellectual capacity, your reference should if 1, 2c, 3, 4, 5 and 6 opposite.
possible cover:
Despatch arrangements
Having supplied the reference, please return it to the applicant.
1 Suitability for the course(s) applied for Seal the envelope, sign across the seal and cover your
signature with clear tape before returning it to the applicant
2 Intellectual qualities including:
(a) development to date and previous examination
performance with special reference
to any factors which may in your opinion have
adversely influenced the result;
(b) present performance;
(c) potential, including an assessment of the
probable results of any pending examinations.
3 Personal qualities
4 Career aspirations
5 Health and other personal circumstances relevant
to the application
6 Athletic, social and other interests
To be completed by the referee
This form may be photocopied: please type if possible, or write in black ink. Please affix official stamp, where appropriate, at the end
of the statement.
Name of referee
Post/Occupation/Relationship
How long have you known applicant
Name of School/College/Organisation
Address
Postcode Country
Telephone No Fax No
Email address
Name of applicant (block capitals or type)
Signed Date
Equal opportunities monitoring form
In completing this form you are helping the University to monitor the fairness of its admissions processes and to ensure equal
treatment for all applicants. This form will be separated from your application and will not be available to the Admissions Tutor.
The information supplied will be recorded on our computer system during the application process and the form will be
destroyed as confidential waste. Please tick the box/boxes that best describe you.
A White D Mixed
British 11 White and Black Caribbean 41
Irish 12 White and Black African 42
Any other White background, please detail 19 White and Asian 43
Any other Mixed background, please detail 49
B Black or Black British E Chinese or other ethnic group
Caribbean 21 Chinese 34
African 22 Any other Chinese background, please detail 80
Any other Black background, please detail 29
C Asian or Asian British F Information refused
Indian 31 98
Pakistani 32
Bangladeshi 33
Any other Asian background, please detail 39
I indicated on my application that I have a disability Yes No
