End of Student Membership Form 2014
GUIDANCE NOTES
What is this form for?
This is a College form for students who have recently finished or are about to finish their
course/receive leave to supplicate. Completing this form signals the end of your student
membership and the start of your alumni relationship with the College.
When does my student membership of the College end?
There are two options for ending your student membership.
Option one: Your student membership ends one month after your University card expires/date you
receive leave to supplicate. However, you will not be able to access the following College facilities
from the date that your card expires/date you receive leave to supplicate:
 Old Main Building
 College Library and Gulbenkian Room
 Computer Room
 Printing/photocopying facilities
You will be able to continue to eat in the Dining Hall using your University card until the end of your
student membership. You may continue to use the Hall after this time and pay with a credit or debit
card, but not at the discounted student rate.
You can receive mail/post into your named pigeonhole until mid-September (students whose
courses finish at the end of September then use the A-Z pigeonholes).
Option two: Alternatively, you can request to end your student membership in full (including
payment by University card in Hall) on a different date between now and one month after your card
expires/you receive leave to supplicate. This date can be before your card expires if you are certain
that you have completed the requirements of your course and no longer require access to any
College facilities.
Make your choice on section 2 of the form.
If you will be continuing to another course at St Antony's College in 2014/15 (e.g. progressing from
a Master’s degree to a DPhil), you should not complete the form now but at the end of your final
course here.
How long will it take for my deposit to be returned?
We will start to process this form from the date you specify in section 2.
We aim to return the deposit as soon as possible; however, during busy periods this may take up to
six weeks. If you are planning to close your UK bank account, please note the approximate closure
date in section 3 and ensure you allow sufficient time for the deposit to be processed and returned.
You can also choose to donate your deposit to the Antonian Fund, which supports a range of
initiatives enhancing all aspects of academic and student life across the College. You will then
become a Member of the St Antony’s College Leavers’ Society. More information about the
Leavers’ Society will be sent to you by the College’s Alumni & Development Office.
See section 3 of the form.
How do I find out more about being an alumnus/alumna of the College?
Once you complete your course, you become an alumnus/alumna of the College and a member of
our global Antonian community. See also the Antonian webpages.
We will keep in touch with you by email and encourage you to send us your updates at
development.officer@sant.ox.ac.uk.
What should I do now?
1. Use the Checklist below to avoid delays in the processing of this form
2. Complete all four sections of the form in full
3. Return pages 2-4 in Word or pdf format to bursary@sant.ox.ac.uk
CHECKLIST FOR ENDING YOUR STUDENT MEMBERSHIP
Check the boxes when you have completed these steps. Note that we can only process this form
in full if you have NO unreturned College library books and the refund of your deposit will
leave you with NO debt to the College.
☐ Cancelled auto top-up of Upay for eating in Hall, ☐ Set up a forwarding email address. You will
if you set this up. You MUST do this before ending
your student membership otherwise payments will
continue to be taken from your debit or credit card.
have access to your Oxford email account for
one month after your card expires and email
forwarding for an additional two months.
☐ Settled any outstanding payments on your
☐ Provided a forwarding address for mail –
battels account (unless covered by your deposit).
ask for a mail forwarding form at the Lodge if
required. Mail will be forwarded for up to three
months.
☐ Returned all library books to College and
University libraries.
END OF STUDENT MEMBERSHIP FORM
SECTION 1. YOUR DETAILS
First (given) name:
Last (family) name:
Personal email address (not @ox.ac.uk):
Mobile phone number (include country code):
Permanent mailing address:
Address:
Post/zip code:
Country:
SECTION 2. DATE THAT YOUR STUDENT MEMBERSHIP WILL END
Your student membership will end EITHER one month after your card expiry date/date you receive
leave to supplicate (although access to the facilities listed on page 1 will end on the card expiry
date/date you receive leave to supplicate) OR on a specific date from now until one month after
your card expires. This form will not be processed until after the relevant date. Specify your choice:
☐ End my student membership one month after my
☐ End my student membership on:
card expiry date / date that I receive leave to
supplicate
Click here to enter a date.
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SECTION 3. COLLEGE DEPOSIT
When you started your course you paid a deposit to the College.
Complete ONE of A or B or C below to indicate what you want to happen to the deposit.
A. Refund my deposit to my UK bank account
Account holder’s name as it appears on your bank
statement:
If you are closing your UK bank account, give
the approximate closure date:
Account number (8 digits):
Sort code (6 digits):
B. Refund my deposit to an international bank account
Payments made to non-UK bank accounts will incur charges. The amount you receive will be the
amount of the deposit minus any costs incurred in making the transfer of funds.
Account holder’s name:
Name of bank:
Account holder’s postal address:
Bank’s postal address:
Address:
Address:
Post/zip code:
Post/zip code:
Country:
Country:
Bank identifier code (BIC or SWIFT):
International bank account number (IBAN):
If your payment will be routed via an intermediary bank, you must also complete these details:
Intermediary bank’s postal address:
Intermediary bank name:
Address:
Intermediary bank identifier code (BIC, SWIFT or
Routing Number):
Post/zip code:
Country:
C. Donate my deposit to the College’s Antonian Fund
Please choose one option from the funding streams in the Antonian Fund:
☐ Warden’s
☐ Travel and
☐ Writing up
☐ Life at St
☐ Academic
☐ Greatest
Scholarships
Research
Bursaries
Antony’s
initiatives
need
(191-AA3-R)
(191-AA5-R)
(191-AA6-R)
(191-AA4-R)
(191-AA7-R)
(191-AA2-R)
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SECTION 4. DATA PROTECTION STATEMENT
Please indicate that you have read and understood the information provided in the data protection
statement by entering your signature and date below.
St Antony’s College seeks to maintain a lifelong association with its Antonians. Information on the
College’s Alumni database is held securely and confidentially by the Alumni & Development Office
for the purpose of effective contact between the College and its alumni. It will be used by the
Development Office for mailing of College publications, the organisation of events and informing you
of fundraising initiatives. St Antony’s College does not sell or give out data to any third party. If
another Antonian wants to contact you we require your consent to pass on your contact details
(without consent we will, however, offer to forward single pieces of post or email to you). However,
alumni email addresses may be given to recognised alumni societies (Liaison Officers) associated
with St Antony's College, so that they can forward you event and reunion invitations. The provision
of this data is subject to a confidentiality agreement, signed by St Antony’s Liaison Officers. If you
would rather not have your email address shared with St Antony’s Liaison Officers, please write an
email to development.officer@sant.ox.ac.uk.
Signature (type your name or insert electronic signature):
Date: Click here to enter a date.
FOR OFFICE USE ONLY (initial on completion, enter £ if required, log on tracker spreadsheet)
ACTION
ENTER £ IF
OUTSTANDING
INITIALS
ACCOUNTS OFFICE:
Registry: flagged if urgent
Hardship loan
£
Registry: contact details
Printing/photocopying
£
Registry: hardship loan
£
Accounts: final battels
£
Library: books
(replacement charge if applicable)
£
Accounts: total due to /
from student
£
Library: door if applicable
Signed:
IT: door if applicable
IT: printing/photocopying
£
Accounts: non-battels debt transfer
Accounts: Uniware transfer
Accounts: deposit transfer
Date:
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