Your details

First name

Surname

Date of birth

Postal address

Enter the full details of your home or main residence address.

House/street

 

Town/city

County

Postcode

Postcode

Email address

This is the email address we will contact you on after you submit this form.

Mobile number

School year

Which school year are you currently in?

Please select...Year 12Year 13I'm not currently in school or collegeI'm a mature learner

What is your gender identity?

Please select...MaleFemaleOther

What is your ethnicity?

Please select...ArabAsian or Asian British - BangladeshiAsian or Asian British - IndianAsian or Asian British - PakistaniBlack or Black British - AfricanBlack or Black British - CaribbeanChineseGypsy or TravellerIrish TravellerMixed - White and AsianMixed - White and Black AfricanMixed - White and Black CaribbeanOther Asian backgroundOther Black backgroundOther Ethnic backgroundOther Mixed backgroundOther White backgroundWhiteWhite - BritishWhite - IrishWhite - ScottishPrefer not to sayNot known

More information

Let us know if any of the following applies to you, so we can see if you're eligible for our Access Plus Programme (link opens in new tab).

I have been eligible for Free School Meals in the last five years

Yes
No

I am a care experienced young person/care leaver

A young person who has spent any time in local authority care, such as foster care or residential children’s homes. It also includes young people who are in, or have been in, kinship care.

Yes
No

I am a young carer

Someone who regularly provides emotional and/or practical support and assistance for a family member who is disabled, physically or mentally unwell, or who misuses substances.

Yes
No

I am the child of a Military Service Family

Yes
No

I am estranged from my family

Estranged students are young people studying without the support and approval of a family network.

Yes
No

I am from a Gypsy, Roma or Traveller background

Yes
No
Prefer not to say

I am a refugee or asylum seeker

Yes
No
Prefer not to say

I am eligible for a college/school bursary

Yes
No

I am a mature learner (21 years of age or older)

Yes
No

I have a disability, learning difficulty or mental health condition

Yes
No
Prefer not to say

Disability details

Let us know which of the following applies to you.

A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D
A social/communication impairment such as Asperger’s syndrome/other autistic spectrum disorder
A long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy
A mental health condition, such as depression, schizophrenia or anxiety disorder
A physical impairment or mobility issues, such as difficulty using arms or using a wheelchair or crutches
Deaf or a serious hearing impairment
Blind or serious visual impairment uncorrected by glasses
A disability, impairment or medical condition that is not listed above
Prefer not to say

How can we support you?

Let us know if there’s anything we can do to support you during the programme.

Your school/college details

Name of your school or college

If you're not currently at school or college, you can write 'n/a'.

Subjects and qualifications

Please list all the subjects and qualifications you are currently studying (e.g. Chemistry A-Level, BTEC etc.) If you aren’t currently in study, list your most recent qualifications.

What subject are you interested in studying at university?

Name as many subjects as you like. You can also say 'unsure' if you don't know yet.

Parent/guardian/carer details

This section should be completed by the parent, guardian or carer unless you are over the age of 18.

The University of Sussex aims to provide a safe and enjoyable experience for every child or young person.

The National Society for the Prevention of Cruelty to Children (NSPCC) recommends that it is a good practice to have a parental consent when enrolling children in one of our settings, so we have relevant information for each applicant.

If you are over the age of 18, please enter n/a.

First name of parent/guardian/carer

Enter n/a if you are over 18.

Surname of parent/guardian/carer

Enter n/a if you are over 18.

Mobile number of parent/guardian/carer

Enter n/a if you are over 18.

Email address of parent/guardian/carer

Enter n/a if you are over 18.

Parents/guardians/carers should now read through the student Code of Conduct and the parents, guardians and carers useful information.

Confirmation

I confirm I have read the information presented. I understand that my young person must adhere to the rules and regulations set out for the duration of the University of Sussex Access programme. I understand that my young person may be prevented from continuing on the Sussex Access programme in the event that they contravene this agreement. I give permission for my young person to attend the Sussex Access Programme, including in-person and online events.

Confirm
Aged over 18 – confirmation not required

Student confirmation and final details

Please read the terms and conditions set out in the student Code of Conduct to be able to participate in the University of Sussex Access Programme.

You should inform your school or college if you will be absent from a lesson due to participating in an activity on the Sussex Access programme.

Programme feedback

We would like to evaluate the success of our programme. Let us know if you are happy to be contacted for research purposes relating to the programme. This will not affect your participation in the programme.

Yes
No

Can our marketing team contact you?

Our Marketing team would like to contact you with further information regarding courses and events available here at the University of Sussex. We will only email you with useful information about the University of Sussex and you can unsubscribe at any time.

Yes
No

Where did you first hear about the Access Programme?

School or college
Email from the University of Sussex
University of Sussex website
Uni4me website
Unifrog
UniTaster Days
Other

Agree to student Code of Conduct

I have read, understood, and agree to the student Code of Conduct for the University of Sussex Access programme. I understand that I must adhere to the rules and regulations set out for the duration of the University of Sussex Access programme. I understand that I may be prevented from continuing on the Sussex Access programme in the event that I contravene this agreement.

Confirm

Please enter the value shown

Data protection

We ask you to provide personal information when completing this form. The information is used to help us to improve access and participation in Higher Education and to ensure that there are equal opportunities for individuals to access and succeed in Higher Education, including the degree outcomes that students achieve and their success in employment. The information provided in this form will only be used by the University for these purposes. Our Privacy notice (link opens in new tab) explains how the University collects and uses personal information and you can find more information about our commitment to processing your personal information in a way that is compliant with data protection legislation in our Access and Participation in Higher Education Privacy notice (link opens in new tab).

We share some of your personal information with the Higher Education Access Tracker (HEAT). HEAT is a nationwide database used by universities to monitor the effectiveness of their Widening Participation and Outreach programmes. Details of how HEAT will process your personal information can be found in HEAT Privacy notice (link opens in new tab.