Department of Social Science, Health & Medicine
Visiting Application Form
Please complete this form and submit with your application form to your
prospective sponsor
Name:
Equal opportunities
Please note that the information collected within this part of the application form will NOT
be submitted for academic assessment.
Policy
King's College London believes that there should be no discrimination (direct or indirect) in relation to
student recruitment, admission and progress on grounds of race, colour, nationality, ethnic or national
origins, gender, marital status, age, sexual orientation or disability. The College aims to promote equality of
opportunity for all and welcomes applications from diverse candidates. The College will take appropriate
steps to ensure that all students are recruited on the basis of academic merit.
Monitoring
Equality monitoring is important in helping the College to ensure our Equality and Diversity Strategy is
effective, which is why we need to collect information regarding ethnic origin and disability/special needs.
Any data collected will be stored securely and used anonymously for equality monitoring purposes only.
The contents of this section will be treated in strict confidence by the Schools' Admissions Offices.
Gender (delete as appropriate)
Male
Female
Other
The ‘Other’ category is to be used by those who do not
identify strongly as either male or female e.g. those
that are intersex, androgyne, intergender,
ambigender, gender fluid, polygender or genderqueer.
Ethnic origin (please choose the option
which most closely describes you)
Black – Caribbean
Black – African
Black – Other
Asian – Indian
Asian – Pakistani
Asian – Bangladeshi
Asian – Chinese
Asian – Other
White
White/Black – Caribbean
White/Black – African
White and Asian
Other Mixed
Other
Prefer not to say
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Disabilities/special needs (please select
the most appropriate)
I do not have a disability
I am blind or partially sighted
I am a wheelchair user or have mobility difficulties
I have mental health difficulties
I have multiple disabilities
I have dyslexia
I am deaf or have a hearing impairment
I need personal care support
I have an unseen disability eg diabetes/epilepsy/asthma
I have a disability not listed above
Prefer not to say
Applicants with disabilities/special needs
King's welcomes applications from students with disabilities/special needs and encourages individuals to
inform us of any specific needs that you may have. If you have a disability, the College can support you in a
number of ways. An information visit with your chosen School or Department is a good opportunity to
discuss any specific needs you may have. For more information, please view our website
Criminal Convictions
To help universities and colleges reduce the risk of harm or injury to their students caused by the criminal
behaviour of other students, they must know about any relevant criminal convictions that an applicant may
have. If you have a relevant criminal conviction, please tick the box. Relevant criminal convictions are only
those for offences against the person, whether of a violent or sexual nature, and convictions for offences
involving unlawfully supplying drugs or substances where the conviction concerns commercial drug dealing
or trafficking. Convictions that are spent (as defined by the Rehabilitation of Offenders Act [1974] are not
considered to be relevant and you should not reveal them. You must tick the box at the end of this section if
the following apply to you.

I have a relevant criminal conviction that is not spent

I am serving a prison sentence for a relevant criminal conviction
If you have a relevant criminal conviction, please tick the box. If you do not, please leave it blank
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