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GUIDELINES FOR APPLICANTS - IMPORTANT!
Please read before you complete your application .
PLEASE CONTACT THE FOUNDATION DEGREE REPRESENTATIVE AT YOUR TRUST
PRIOR TO APPLYING.
Deadline for Applications for September 2016 – 20th May 2016
1.
Section A: Personal details
Surname/family name and first name(s): Please enter your full name as it appears in your passport or other official
documentation.
Previous Surname(s): If you have changed your name by marriage or otherwise, state your previous surname/family name(s).
Correspondence Address: Please ensure you provide your up-to-date contact details as we will need to contact you during the
admissions process. You must also notify us of your change of address without delay.
Name of the Trust: Please ensure that you provide the name of the NHS Trust or organisation (CCG) you are currently working
for.
Entry Year- Applications are only reviewed for the current academic year. We do not consider deferred entries.
2.
SECTION B: Employment Details
Please include all relevant work experience.
3.
SECTION C: English Test
You will be required to provide your English Language certificate at interview if English is not your first language. Score required
for IELTS exam is 6.0 points.
4.
SECTION D: Educational Qualifications
Clearly state your educational qualifications with the most recent first. One of the entry criteria for the course is ‘accredited study
within the last 5 years’. Please ensure you have stated this in your application. You will be required to bring your original
certificates at interview.
5.
SECTION E: Personal Statement
Enter any further information you may wish to offer in support of your application. The Admissions Tutor will be interested in
your reasons for choosing the course, your career aspirations, and relevant experience.
6.
SECTION F: References
IMPORTANT! - Please provide us with your referees’ up-to-date contact details (we will need their telephone number and e-mail
address) and their institutional or employment affiliation.
Please download the reference forms and ensure both your referees complete and sign them. Send your references with your
application. Failure to do so will delay or halt your application process.
Please send one completed application Electronically to the admissions tutor:
j.d.seal@bton.ac.uk
and a copy to admissions:
namadmissions@brighton.ac.uk
FOR OFFICE USE ONLY
Date received…………… Shortlisted by ………………………….. Interview? Yes/No ……………..
Interview date………….………………… Intake………………..
Comments……………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………….
______________________________________________________________________________________________
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SCHOOL OF HEALTH SCIENCES
Westlain House, Village Way, Falmer, Brighton, BN1 9PH
Telephone 01273 600900 Fax 01273 644010
Foundation Degree Science (FDSc) Health and Social care Practice
APPLICATION FORM
Please complete ALL SECTIONS
SECTION A
PLEASE COMPLETE THIS SECTION IN BLOCK CAPITALS
(Mr/Mrs/Miss/Ms) First name(s):
Surname:
Previous Surname(s):
Date of Birth:
Address:
Tel No (Home):
(Mobile):
(Work):
Fax No:
Post Code:
Email address:
Do you hold a current Car Driving Licence? Yes/No
Do you have a car that you would be willing
to use for work? Yes/No
Nationality:
Have you previously applied to attend a course at this University? Yes/No
If yes, please give details of date and course:
How did you become aware of this course?
Have you any disability to declare? Yes/No
Please give details of your sponsoring Trust/Organisation:
SECTION B
PRESENT EMPLOYMENT
Name of Employer:
Address:
Grade:
Salary:
Please give a brief outline of the present role and responsibilities of your work:
PREVIOUS EMPLOYMENT
Please provide the names and addresses of any previous employers, from the last 10 years, most recent first. If less
than 3 posts have been held in the last 10 years please provide details of earlier experience.
Employer
Position held / Grade
Dates
Reason for leaving
SECTION C
When English is not your first language please state English Language qualifications held.
Name of Test
Date taken
Score
Notes
SECTION D
Educational Qalifications (Most recent first)
Type of Qualification
(eg. GCSE NVQ)
Subject
Grade/Level
Date of
Completion
Education Provider
SECTION E
PERSONAL STATEMENT
Please state why you wish to undertake the Foundation Degree course and provide any other relevant information in
support of your application including the feedback from your discussion with a Trust supervisor. (You may continue on
a separate sheet if necessary.)
Please provide the name of the Trust supervisor that you have discussed your application with:
Name: __________________ Surname: _____________________
Post: ____________________
SECTION F
Two references will be required in order to process your application. Ideally one should be from an Education
Establishment (attended within the last 5 years) and the other from someone who has known you in a professional
capacity (i.e. employer). Please note the more information you can provide about your referee the quicker your
application can be dealt with.
Recent Educational Referee
Recent Employer Referee (Manager or Supervisor)
Name
Name
Occupation/Post/Relationship to you
Occupation/Post/Relationship to you
Address
Address
Telephone No
Telephone No
Fax No
Fax No
Email
Email
SECTION G
Rehabilitation Of Offenders Act
The educational programme for which you are applying is exempt form the Rehabilitation of Offenders Act. This means
that you must declare any criminal convictions even if they are spent. (Please note that a conditional discharge is a
conviction.)
Have you ever been convicted of any criminal offence, bound over or cautioned? Yes/No
Have you had a Disclosure and Barring Service check by your self/employer? Yes/No
Month/year of DBS :
______________________________________________________________________________________________
DECLARATION
I confirm that the above statements are true and correct, and understand that any misrepresentation will invalidate my
application and, if employed, could lead to dismissal. I am prepared to undergo a medical examination if required and
confirm that to the best of my knowledge there are no medical reasons which would prevent me from undertaking
duties of the post.
Signature .......................................................
Date .............................................
______________________________________________________________________________________________
Please return one completed form (electronically to the admissions tutor:
j.d.seal@bton.ac.uk
and a copy to admissions:
namadmissions@brighton.ac.uk