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First Name:* |
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Surname:* |
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Student ID:*
University Issued student registration number |
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School:*
Please select your school from the drop down list |
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Year of study (Please select your year of study for Academic Year 2012/13) |
Foundation
1
2
3
4
5
6
Other:
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Gender* |
Male
Female |
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Date of Birth:* |
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Student Status:* |
Home Student
International
EU |
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Mode Of Study:* |
Full Time
Part Time |
Main Campus:*
Please select your school from the drop down list |
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Areas of Interest:* |
Advice and Guidance
Animals
Arts, Media and Creative
Business, Marketing and Finance
Children
Education
Environment
Fundraising
Health and Caring
IT and Computing
Languages
Law
Museums & Heritage
Psychology
Social and Community Work
Sports and Leisure
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Do you consider yourself to have a disability?:* |
Yes
No
Prefer not to say |
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Do you have your own transport?:* |
Yes
No |
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Telephone number*: |
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Email address:* |
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Address:* |
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Post Code* |
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Emergency contact name:*
Next of kin (family member or friend) to be contacted in case of emergency. |
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Emergency contact telephone number:* |
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Emergency Contact Relationship
How do you know this person?* |
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Where did you hear about the UUSU Volunteering Centre? |
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I (Being over the age of 18 years) give my consent for UUSU to publish my name and any still photographic images or video footage of me that they have gathered. (please tick box). |
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