Application form

Your details

Family name

Given name

Title (Mr/Miss/Ms/Mrs/Other):

Your UCAS personal ID:

If you are not in UCAS, please leave blank

Have you applied to the University 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)

Gender

Male Female

Country of permanent residence

Country of birth

Nationality (as stated in your passport)

Residential status in the UK

Please can you confirm if you are a UK national who has lived continuously in the UK/EU since 1 September 2021?

Yes No

Do you require a visa to study in the UK?

Yes No

Please provide your passport number

Please provide your passport expiry date

Please provide your UK entry date

We will use the passport information, if you are successful, to provide the Confirmation of Acceptance for Studies (CAS) you will need in support of your visa application.

Course details

Course applied for:

Medical Neuroscience (BSc) [B142]

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.

Important Information

This section requires precise information about your qualifications. When entering your qualifications on this form please note that you should use the exact title of the qualification taken in your own language. Do NOT try and translate your qualifications into British A-levels or any other system. Our Admissions Team will do this when we receive your application form.

We need information on all the qualifications you have taken since you were 16 and will also require evidence of English language proficiency in the form of IELTS or an equivalent qualification. Further details of our English language requirements can be viewed in our prospectus. Please note that some of our degree programmes also require a good standard of mathematics. Please check the individual subject entries in the prospectus for further details.

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.

International Baccalaureate

Use these boxes for International Baccalaureate only

A Levels/AS Levels

Use these boxes for British GCE A Levels/AS Levels or UCLES/Cambridge A levels only.

English Language Qualifications

Is English your first language?

  Please selectYesNo

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

Other qualifications

Please list name of qualification, subjects taken, grades obtained, country in which taken and when.

Application support

Personal statement
Please use this section to support your application. The personal statement is an important part of the application process and Admissions Tutors will be looking for a series of paragraphs explaining your reasons for applying for your chosen course, your interests and any relevant experience that you have.

 

Referee details:

Please provide the name and contact details of someone we can approach for an academic reference.

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 University 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 University 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 University 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 University’s privacy notice.