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LJMU Lifestyles: Student Application Form

This document contains a student application form for Arnaud Fournier to study at LJMU starting in October 2020. It requests basic contact and demographic information such as name, date of birth, address, ethnicity, and disability status. The form notes that providing racial origin data is optional but will help improve access to Liverpool City Council services, and that all information collected will be processed according to data protection laws.

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35 views1 page

LJMU Lifestyles: Student Application Form

This document contains a student application form for Arnaud Fournier to study at LJMU starting in October 2020. It requests basic contact and demographic information such as name, date of birth, address, ethnicity, and disability status. The form notes that providing racial origin data is optional but will help improve access to Liverpool City Council services, and that all information collected will be processed according to data protection laws.

Uploaded by

TIC Techa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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LJMU Lifestyles Produced:10/10/2020 14:19:43

Ref: d53467c973d8

Student Application Form


LJMU ID Number: LJMU10159028 Date of Application: 10 October 2020

Title: Mr Forename: Arnaud Surname: Fournier

Programme of Study:

Start Date: Expected Completion Date:

Term Time Address:

Postcode:

Date of Birth: 25/05/1999 Male: Female:

Telephone:

Email:

Liverpool City Council is committed to making sure that our services are accessible to all members of the community. You do
not have to answer the following questions about racial origin but if you do, it will help us improve access to our services.

What best describes your racial origin ?

Asian or Asian British Nigerian White


Asian British Somali White British
Indian Any Other Black Background White Irish
Pakistani Chinese or Other Ethnic Group Any Other White Background
Bangladeshi Chinese Mixed
Any Other Asian Background Yemeni White and Black Caribbean
Black or Black British Gypsy White and Black African
Black British Traveller White and Asian
Caribbean Other (give details) Any Other Mixed Background
African _________________________ Prefer not to say
Information not obtained

Do you consider yourself to be a disabled person? Yes No

Signature:

This agreement is between Liverpool City Council and individuals. Terms and conditions apply. All
information collected by Liverpool City Council is processed in compliance with the Data
Protection Act, 1998.

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