APPLICATION FOR UNDERGRADUATE ADMISSION TO:

BSc Information & Library Studies by Distance Learning

SECTION 1: PERSONAL DETAILS
Surname/Family Name: / First Name, Second Name: / Former Name (where applicable):
Title
(Dr, Mr, Mrs, Miss, Ms) / Date of Birth:
(day/month/year) / Sex:
Male / Female / Country of Birth: / Nationality:
Permanent Home Address: / Address for Correspondence (if different):
From Date: To Date:
Post/Zip Code: / Post/Zip Code:
Tel: / Tel:
Mobile: / Mobile:
Fax: / Fax:
E-mail: / E-mail:
Residential Information
Have you resided in the UK/EU continuously, with the exception of vacations or periods of study since birth? YES or NO
If YES go to Section 2. If NO, please answer the following questions:
If NO, please state precisely where you have been resident during the last 10 years (including periods spent in education) (use a separate sheet if necessary):
Are there are any restrictions on your eligibility to reside/work in the UK? YES or NO
If YES, please specify restrictions:
If you require a student visa in order to study in the UK, please provide your passport number:
SECTION 2: QUALIFICATIONS

QUALIFICATIONS HELD(Please attach copies of transcripts and certificates where appropriate)

University/Institution attended (with dates) / Degree / Qualification title / (Main) Subject / Classification or Grade / Date of Award

CURRENT STUDIES

Current University/Institution (with dates) / Degree / Qualification expected / (Main) Subject / Expected Date of Award

Professional Membership

Institution / Dates

PERSONAL STATEMENT

Please give details of any information, including relevant employment or professional experience, which may be important to your application (use a separate sheet if necessary). Candidates should state whether employment was full time or part time and give dates.

SECTION 3: PROPOSED STUDY AT ABERYSTWYTH (Please complete this section fully)
Department of the University to which you seek admission / DEPARTMENT OF INFORMATION STUDIES
Title of course: / BSc Information & Library Studies by distance-learning
Proposed Start Date: / June
StudySchool Location:
Proposed Source of Finance:

N.B.Please note that there are separate applications forms for Research Programmes (PhD, MPhil and LLM by Research) and for Taught Masters courses.

SECTION 4: PRESENT EMPLOYMENT
CURRENT EMPLOYMENT STATUS:
CURRENT EMPLOYMENT CONTACT DETAILS:
Address:
Tel: / Fax: / E-mail:
SECTION 5: REFERENCE

Please complete Section 1 of a copy of the Undergraduate Reference Form and send itto your referee.

Please note below the name and address of the person who will supply a reference in support of your application. Delays in communicating decisions to applicants are often caused by failure of referees to respond to requests for information so you should ensure that the person nominated is in a position to reply.Please note that you must obtain this reference from your referee. We will not contact your referee on your behalf

Applications will not be considered until the reference form has been received.

Referee Name (including title)
Address:
Post/Zip Code: / Tel:
Fax:
E-mail:
SECTION 6: OTHER INFORMATION

SOURCE OF INFORMATION

From what source did you find out about this opportunity for undergraduate study?

ENGLISH LANGUAGE PROFICIENCY- International Students only

English is my native / first languageYes orNo
If English is not your native language it is essential that you provide evidence of your competence in written and spoken English (e.g. TOEFL or IELTS scores). See

Welsh language ability - UK Students only

Do you understand Welsh?Yes or No [N.B. This information is collected for statistical purposes only.]
If YES, would you like us to communicate with you in Welsh? Yes orNo

DISABILITY / MEDICAL CONDITIONS / ADDITIONAL REQUIREMENTS

Do you have one or more of the following?Yes orNo
If YES, please tick the appropriate box or boxes below and give further details:
Dyslexia / Mental health difficulties
Blind / partially sighted / Medical conditions, e.g. diabetes, epilepsy, asthma
Deaf / hearing difficulty
Autism / Wheelchair user
 You have mobility difficulties
You require personal care support / You have two or more of the above disabilities/conditions
You have a disability not listed above
Please give further details
The University will consider this information and discuss with you whether any adjustments will be necessary. The information you provide will not affect judgements concerning your academic suitability, and will be treated confidentially.
UK Students only: please check for further information on the Disabled Students’ Allowance.

CRIMINAL CONVICTIONS:

Do you have any relevant/unspent criminal convictions?Yes orNo
SECTION 7: DECLARATIONS
In the event of, and in consideration of, the University accepting me as a student, I hereby undertake to pay, as and when due, all University fees.
I consent to the University's use of my personal data, some of it sensitive data, in order that it might fulfil its administrative obligations and in order that my application might be processed
I hereby certify that all the above information is correct and complete, and I desire to apply for admission as a student of the University and declare that, if admitted, I shall conform to all the Rules and Regulations of Aberystwyth University. I understand that the submission of any misleading information during the admissions process could lead to the immediate cancellation of my application and the withdrawal of any offer made.
Signature of Applicant...... Date......
All personal data provided by you will be treated strictly in accordance with the Data Protection Act 1998

This form should be completed and returned as soon as possible in duplicate to:

POSTGRADUATE ADMISSIONS OFFICE, CLEDWYN BUILDING, ABERYSTWYTH UNIVERSITY,
PENGLAIS CAMPUS, ABERYSTWYTH, CEREDIGION SY23 3DD, UNITED KINGDOM

Tel: +44 (0) 1970 621957 Email: Fax: +44 (0) 1970 622921