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Your details

Family name

Given name

Title:

Your UCAS personal ID

If you are not in UCAS, we cannot consider an application. Please .

Have you applied to the Â鶹´«Ã½ of Sussex before?

Yes No

Contact address

Postcode/Zipcode

Home address (if different from above):

Telephone number

Email address

Email address (confirm)

Date of birth (DD/MM/YY)

Country of permanent residence

Country of birth

Nationality

Course details

Course applied for:

Chemistry with Summer Research Placements (MChem) [F107]

Qualification details

Please fill out relevant subject areas for A-level/AS Levels, International Baccalaureate and Access to HE Diploma. For all other qualifications complete the other qualifications box.

A Levels/AS Levels

International Baccalaureate

Access to HE Diploma

Please provide details of your Level 3 credits achieved in the boxes below:

GCSEs

Other qualifications

Please list name of qualification, subjects taken, grades obtained, where taken and when.

Scanned qualifications

You may find it easier to scan and attach copies of your qualifications including English Language qualifications to help speed processing of your clearing application.

The form may take some time to submit depending on size and quantity of files you attach.

English Language Qualifications:

If your first language is not English, please indicate what English Language qualifications you have (for example, IELTS, Pearson's Test of English (Academic), Cambridge Advanced Certificate in English, IGCSE)

Application support

Personal statement
Please use this section to support your application by providing reasons for applying, your interests and relevant experience

 

Referee details:

Name:

Relationship to applicant:

Email address:

Telephone number:

Address:

Additional information

Admissions tutor

Can an admissions tutor contact you?

Yes No

Special needs or disability

The Â鶹´«Ã½ welcomes applications from students with disabilities. Our Student Support Unit will want to contact successful applications who have a declared disability or special need to discuss what support the Â鶹´«Ã½ can provide. Therefore please complete the following to indicate what, if any, disability or special needs you might have:

No disability Social/communication impairment such as Asperger's Syndrome/other autistic spectrum disorder Blind or have a serious visual impairment uncorrected by glasses Deaf or have a serious hearing impairment Long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease or epilepsy Mental health condition, such as depression, schizophrenia or anxiety disorder Specific learning difficulty such as dyslexia, dyspraxia or AD(H)D Physical impairment or mobility issues, such as difficulty using your arms or using a wheelchair or crutches Disability, impairment or medical condition that is not listed above

Please specify:

Two or more impairments and/or disabling medical conditions

Please specify:

Declaration

Please tick to confirm that that the information provided in this form is true, accurate and complete, and that no information has been omitted. Please be advised that any offer can be withdrawn if information provided proves to be inaccurate.

Note that the information provided in this form will be used for the purposes of processing your clearing application to study at the Â鶹´«Ã½ of Sussex and to contact named referees where necessary. Any personal data provided is processed in accordance with the General Data Protection Regulation and the Data Protection Act 2018, and the .