Stranmillis University College Student Support Questionnaire 2022-2023

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Thank you for choosing to study at Stranmillis University College.

The University College intends to ensure that all our students have appropriate information, support and facilities to enable them to participate fully in all aspects of University College life. This can be done most effectively if we have an understanding of any special requirements you may have including any Health & Safety consequences associated with a disability or medical condition.

Therefore please complete and submit this questionnaire as soon as possible, including as much information as possible regarding your condition(s).

Please note the following:

The College cannot accept responsibility if the result of this questionnaire is affected by omissions, incomplete or inaccurate information supplied by the candidate.
We will process your data in line with the privacy statement on the Stranmillis University College website: https://www.stran.ac.uk/about-us/governance/freedom-of-information/
Partially completed questionnaire forms may be accessible by College staff.

At the bottom of each page you will see a 'save and continue later' option. It is recommended that you do this on a regular basis, just in case your browser crashes and you lose the information that you have entered.

If you have any questions or difficulties in completing this form please contact us via e-mail (studentsupport@stran.ac.uk).

1. Personal Details *

Surname	*
Forename(s)	*
UCAS ID (if known)	*
Email Address	*
Home Phone Number	*
Mobile Phone Number	*

2. Date of Birth *

	DD/MM/YYYY

3. Full home address: *

Address Line 1	*
Address Line 2 (if required)
City/Town	*
County	*
Postcode	*

4. Full term-time address:

Address Line 1
Address Line 2 (if required)
City/Town
County
Postcode

5. FIRM CHOICE

If you are holding a firm choice at Stranmillis University College, please select the course below.

6. INSURANCE CHOICE

If you are holding an insurance choice at Stranmillis University College, please select the course below.

7. Disability Support Requirements - Visual

Do you have a Visual Disability (this does not refer to the wearing of glasses or contact lenses)?

Please select as appropriate. *

No
Yes