Record of Third Party Consent to Share 2011/12 Student Funding Applications for undergraduate or ITT study In order that an advisor from the university can speak to Student Finance England regarding your application for student funding on your behalf without the need for you to be present, you must first contact Student Finance England and give permission for your information to be shared with a third party. To set up Third Party Consent to Share*: Contact Student Finance England: 0845 300 5090 Request to set up “Third Party Consent to Share” Create your own “Consent Password” Ask that “Consent to Share” be given to “the advisory team at my university” Complete the details requested below and sign the declaration, then return this form to Ms Karen Bentley, Student Centre, Chancellor’s Mall: Name:………………………………………………………………… Student i.d. number:……………………………………………… Date of Birth:……………………………………………………….. Customer Reference Number:…………………………………… Consent password:……………………………………………….. Telephone number:……………………………………………….. Student email address:………………………………………….. In giving third party consent to share to the advisory team at my university I am agreeing that they may contact Student Finance England on my behalf, without my presence, with regard to any matters relating to my student funding with the exception of financial information, bank details or information on any disability I may have. I understand that any information received will be strictly confidential. Signature:………………………………… Date:………………………………………. *Third Party Consent to Share is not consent to share for bursary and scholarship purposes