Hall of Residence Information Form
For internal use only by the Hall Warden
Section 1 - Your details:
Student ID: *
* found on page 2 of your offer letter
Surname (in full):
Forename(s):
Sex (tick)
Preferred Name:
Male
Female
Home address:
Mobile Number:
Date of birth:
Nationality:
Section 2 - Emergency contacts (in the UK if possible, for overseas students):
Contact Name (1):
Address (1):
Email (1):
Telephone (1):
(Daytime)
(Evening)
(Mobile)
(Daytime)
(Evening)
(Mobile)
Contact Name (2):
Address (2):
Email (2):
Telephone (1):
Section 3 – Academic information and interests:
Your course:
Year at University:
First
Second
Third
Other (please specify)
Last college or
school attended:
Gap Year (spent working
or travelling etc):
General interests - for
example music, drama,
sports, religious activity etc:
Section 5 -Disabilities / Requirements and Medical Conditions:
Do you consider yourself to have any disabilities or any specific requirements (please provide details):
Do you have any other medical conditions that may affect your health and safety, or that of others, while at the
University (i.e. diabetes, asthma, epilepsy or special dietary requirements) that we should be aware of:
If you have already applied for your University Card then we will use your supplied photograph as
additional information to this form.