Application for OpenPlus Physics with The Open University & the University of York Please complete this form and return it to: Physics Undergraduate Admissions (PT103) Department of Physics, University of York, YORK, YO10 5DD or email in PDF form to [email protected]
APPLICANT INFORMATION
Surname/family name Title
First names in full
Date of birth ☐Male ☐Female Address line 1 Telephone (Day)
Address line 2 Telephone (Evening)
Town/City Telephone (Mobile)
Postcode
E-mail Address Country of legal nationality Have you studied with OpenPlus before? Yes☐ No☐
Where did you hear of OpenPlus?
☐UCAS ☐ The Open University ☐ The University of York
Other (please state):
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Your Personal Information As an OpenPlus applicant/student, you will have a relationship with both The Open University and the University of York. Both The Open University and the University of York are data controllers, this means that both universities will decide why and how your personal information is processed. The Open University privacy notice sets out how The Open University use your personal data: http://www.open.ac.uk/students/charter/essential-documents/student-privacy-notice The University of York privacy notice sets out how the University of York use your personal data: https://www.york.ac.uk/about/legal-statements/ https://www.york.ac.uk/records-management/dp/your-info/students/ In addition to the privacy notices above, information you provide is shared between The Open University and the University of York for the purposes of managing, monitoring and evaluating the OpenPlus scheme. This will include your application, results and progress on the scheme. We will also share information you provide to support a request in relation to resitting an examination, delaying progression, or changing your agreed study pathway.
Application for OpenPlus Physics with The Open University & the University of York
Personal statement
Please describe your reasons for wanting to study OpenPlus Physics with Open University and the University of York. Please include any relevant experience or qualifications and outline your interests and skills:
Full Name:
I certify that all the information provided is correct.
Signed Date
To be completed by the University of York
Physics OU Module Pathway: MST124, SS001, MST224, S217, SXPA288
Year of Progression _._._._._._._._._._._._._._._
Admission Tutor’s authorising signature _._._._._._._._._._._._._._._XXXXXX Date_._._._._._._._._._._._