Embedded Student Application Form

Title*

First Name*

Last Name*

University*

Degree Programme*

Start Date*

End Date*

Year of study*

Email Address*

Address Line 1*

Address Line 2

Town/City*

County

Postcode*

Country*

Mobile Number*

Communication preferences*

Yes! I would like to receive information from the IFA.

No I would not like to receive information.

(If yes) I would like to receive information via:

Email

Post

Telephone

Mobile (text message)