Application Form

Applications are now open for the 2023/24 Outreach programme.

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

Our data protection statement can be found on the tab above.

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

Outreach programme application form - 2022-23

Student details

Please answer questions as fully and honestly as possible so we can assess your eligibility
Enter Email
Confirm Email
Please select your institution from the list if it is given, to help us to process your application quickly. If it is not listed, please select 'other' and type the name.
What year would plan to start university, if you were to apply?
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"

Student questionnaire

Tick one box for each question

Subject interests

Please select any that are of interest to you - this helps us to show you activities that match your tastes.

Parent/carer contact details

Please check with your parent, carer or legal guardian for the correct details, and complete this part of the form carefully. We would like to write to them and tell them about the programme and events we run for parents/carers. We also need to be able to contact them in case of an emergency while you are at one of our events. Young people in the care of the local authority should give the details of their social or key worker.
Enter Email
Confirm Email
A number that we can use in case of an emergency while you are at one of our events.


Please type your name

Confidential equal opportunities monitoring

Please tick the appropriate boxes

Thank you

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

WP Data Protection statement
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