Application Form

Applications are open for the 2024/25 Outreach programme.

Please complete the form below to let us know of any circumstances you would like us to take into consideration. We look at each application individually. The Outreach team retains the right to make a final decision on eligibility to the programme.

Our privacy notice and our widening participation criteria can be found on the tabs above.

If you have any questions about this form please email outreach@brighton.ac.uk

Outreach programme application form 2024-25

Student details

Please answer all the questions below so we can assess your eligibility.

Name *

Name

First

First

Last

Last

Address *

Address

Town *

County *

Postcode *

Email address *

Please type this carefully and make sure it's correct as it's the main way we will contact you.

Date of birth *

Please use the calendar to enter your date of birth.

Current 6th form or college * Please selectAngmering School, TheArk Alexandra AcademyBeacon AcademyBexhill CollegeBishop Luffa SchoolBrighton Aldridge Community Academy (BACA)Brighton Hove and Sussex Sixth Form College (BHASVIC)Cardinal Newman Catholic SchoolChichester CollegeChichester High SchoolCollege of Richard Collyer, TheCrawley CollegeDv8 SussexEast Sussex College Group - EastbourneEast Sussex College Group - HastingsEast Sussex College Group - LewesFelpham Community CollegeGreater Brighton Metropolitan College (GB Met / Northbrook College)Hailsham Community CollegeHaywards Heath CollegeHazelwick SchoolHeathfield Community CollegeHoly Trinity CofE Secondary School, CrawleyHove Park SchoolIfield Community CollegeImberhorne SchoolKing's SchoolLittlehampton Academy, TheMidhurst Rother CollegeNorthbrook CollegeOriel High SchoolPlumpton CollegeRegis School, TheSackville SchoolSeaford Head SchoolShoreham AcademySir Robert Woodard Academy, TheSt Paul's Catholic CollegeSt Philip Howard Catholic SchoolSt Wilfrid's Catholic School, CrawleySteyning Grammar SchoolThomas Bennett Community CollegeUckfield CollegeUplands Community CollegeVarndean CollegeWeald School, TheWorthing CollegeOther Current 6th form or college

Local Sussex institutions are listed but you can apply wherever you study. If your sixth form/college is not listed, please select 'other' and type in the name.

Current year group *

Year 12 (1st year of sixth form or college)

Year 13 (2nd year of sixth form or college)

Access to HE course

Other Other

What year would plan to start university, if you were to apply? *

2025

2026

2027

2028

Previous secondary school, if different to the above *

About you

Are you, or have you ever been, in care of the Local Authority or under a special guardianship order? *

Yes

No

Are you a young carer? *

Yes

No

Have you lost contact with your family? Often referred to as estranged, but not in the care of the Local Authority. *

Yes

No

Do you currently, or have you ever, lived in supported accommodation? *

Yes

No

Do you have refugee or asylum seeker status? *

Yes

No

Do you have a diagnosed disability (physical or learning)? *

Yes

No

Definition of disability - an explanatory note. The Equality Act 2010 defines disability as: "a physical or mental impairment, which has substantial and long term adverse effect on a person's ability to carry out normal day-to-day activities"

If yes, what is the nature of your disability? * Please selectTwo or more impairments and/or disabling medical conditionsA specific learning difficulty such as dyslexia, dyspraxia or AD(H)DA social/communication impairment such as Asperger's syndrome/other autistic spectrum disorderA long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsyA mental health condition, such as depression, schizophrenia or anxiety disorderA physical impairment or mobility issues, such as difficulty using arms or using a wheelchair or crutchesDeaf or a serious hearing impairmentBlind or a serious visual impairment uncorrected by glassesA disability, impairment or medical condition that is not listed abovePrefer not to say

Do you receive the 16-19 Bursary Fund? *

Yes

No

Did you receive free school meals while you were at secondary school? *

Yes

No

Are you studying an Access to Higher Education course, or are you a mature student? *

Yes

No

Subject interests

Which of the following subject areas are you interested in? *

Accounting, finance and economics

Allied health professions

Architecture and design

Biology and ecology

Biomedical science

Business and management

Civil engineering

Computing

Construction and building

Creative writing

Criminology and sociology

Education studies

Engineering

Fashion, textiles and 3D design

Film

Fine art

Geography, Earth and environment

History of art and design

Humanities

Journalism

Language

Law

Literature

Marketing, tourism and events

Media

Nursing and midwifery

Pharmacy

Photography

Politics

Professional development in health

Public health

Social work

Sound and music

Sport and exercise

Teaching

Visual communication

Please select any that are of interest to you.

Confidential equal opportunities monitoring

Gender *

Male

Female

Gender fluid

Prefer not to say

Ethnicity * Please selectArabAsian or Asian British - BangladeshiAsian or Asian British - IndianAsian or Asian British - PakistaniChineseOther Asian backgroundMixed - White and AsianBlack or Black British - AfricanBlack or Black British - CaribbeanOther Black backgroundMixed - White and Black AfricanMixed - White and Black CaribbeanIrish TravellerGypsy or TravellerWhite - BritishWhite - IrishWhite - ScottishOther White backgroundOther Ethnic backgroundOther Mixed backgroundPrefer not to say

Agreement

The information I have given is complete and accurate. By submitting this form I confirm I have read and understand what my data will be used for, and what I can expect from the outreach programme. This includes targeted and appropriate communications from the University of Brighton, including being notified of activities which are part of the university's widening participation offer. I understand that my data will be used as set out in the WP Outreach privacy notice, and that I can opt out of communications at any point. *

Yes

Student signature *

Please type your name

I am happy to be contacted for research purposes by the University of Brighton

Yes

Thank you

We will contact you as soon as possible to let you know the outcome of your application.

WP Outreach privacy notice
University of Brighton privacy notice for prospective students

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