NameClick here to enter text.K NumberClick here to enter text.
EmailClick here to enter text.PhoneClick here to enter text.
How did you hear about us?Click here to enter text.
Please let us know if you have a preferred pronounClick here to enter text.
Are you a…Home/UK student ☐EU student ☐International student ☐
What is your nationality?Click here to enter text.
What gender do you define into? (if any)Click here to enter text.
Do you consider yourself to have a physical or mental disability, or long term health condition?
Yes ☐please specifyClick here to enter text. No ☐Prefer not to say☐
Do you have caring responsibilities (children or adult dependents)? Yes ☐No☐
Would you describe yourself as estranged from your family? Yes ☐No☐
Please choose the ethnicity that best describes your background
Asian or Asian British☐Bangladeshi
☐Indian
☐Pakistani
☐Chinese
☐Another Asian background, please specifyClick here to enter text. / White
☐British
☐Other European
☐Romani
☐Any other white background, please specifyClick here to enter text.
Black or Black British
☐African
☐Caribbean
☐AnotherBlack background
please specifyClick here to enter text. / ☐Arab
☐Another ethnic background, please specify
☐Mixed Heritage
☐Prefer not to say
WHAT YOU NEED TO KNOW ABOUT THIS FORM
We ask you to provide us some information so that we can know more about you and your enquiry. This helps us to give you the most accurate advice. This information is stored on our confidential case file system for 6 years, after which it is deleted. Any information that we store is done so under our Data Protection Act obligations and our Confidentiality Policy. We treat your information with respect and keep it safe and secure. You can request access to your case file and any information we hold relating to you by emailing us . We will do our best to process any such request within 10 working days, and if we’re not able to do this we will contact you and let you know when we will be able to.
We also use this information to monitor our service provision, and make sure that our advice is accessible to all our students. Data that is used for equality monitoring is anonymised statistics only, your name, student number or any identifying information about your enquiry will never be associated with our monitoring data, and will never be used without your permission.
If for any reason you are uncomfortable with us holding or using your information in this way please let your caseworker know. You are in control of your information at all times when working with KCLSU advice.
KCLSU advice is free, confidential, independent and impartial, empowering, non-judgmental and straightforward.
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