Application form - University of Essex Online

Application form 

1. Fill in all sections of the form 

2. Attach certified copies of academic transcripts and exam results 

3. Send the completed application to University of Essex Online (details overleaf) 

This is the start of a simple process enabling you to enrol onto your online degree programme. Firstly, we require some background information 

about you to help us make a judgement about your eligibility to join the programme. If you are successful we then take up references or speak to 

your employer before being able to offer you a place on the course. Please don't hesitate to call our Admissions Advisers on 0113 388 8888 if 

you have any questions about your enrolment. 

1. Contact details 

Title: 

Address: 

Family name or surname (as on 

passport): 

First name(s) (as on 

passport): 

County: 

Country: 

Postcode: 

Gender: 

Male 

Female 

Telephone: 

Mobile: 

Date of birth (dd/mm/yy): 

Nationality: 

Email address: 

Country of permanent residence: 

Country of birth: 

Number of years lived in your 

country of permanent residence: 

Ethnicity: 

2. Course and payment details 

We will always talk to you prior to making an offer to ensure that you have chosen the programme and start date that work best for you. 

Course: 

Anticipated start date: 

PAYMENT FOR THE COURSE: 

Course fees and payment options are outlined in our prospectus and on our website. We offer payment by module, level and degree. There may 

be other sources of assistance available and our team will guide you through the application process. At this stage we only need an initial 

indication of how you propose to pay. 

Please indicate by selecting those applicable: 

Self-funded Employer-funded Financial assistance 

If you wish to apply for grants and/or loan assistance, we will need to know your annual household income and number of dependents as well as 

some other details later in the process - completion of the details at this stage is optional. (This is not applicable to international students) 

Annual household income: £ 

Number of dependents: 

3. Education and work history 

Academic route 

Successful applicants to the programme will have a combination of academic qualifications, experience and motivation and show the potential to 

complete their chosen course successfully. Any successful application must meet the minimum standards that we have agreed with University of 

Essex. Essentially we are looking for an academic minimum of either an A Level or an NVQ3. 

Alternative route 

Applications from students without formal academic qualifications are welcome. Such applicants must have relevant and significant experience 

of the working environment and have the requisite skills (including and in particular English language skills) in order to cope with the demands of 

the course. We will look to approve either prior qualifications, training, or assess your work experience. Full details of the academic route or the 

alternative route are available on our website. 

You are welcome to discuss the AP(E)L process with our advisers prior to submitting your application. 

University of Essex Online degrees are delivered by Kaplan Open Learning, an experienced online learning provider. 

University of Essex Online, West One, 114 Wellington Street, Leeds LS1 1BA 

T +44 (0)113 388 8888 | F +44 (0)113 388 8899 | E enquiries@online.essex.ac.uk 

http://online.essex.ac.uk


Please provide full details of any academic or professional qualifications: 

Institution (name and country) Dates attended (from – to) Qualification awarded Result 

Please provide full details of your employment history: 

Place of employment Dates (from – to) Positions held/duties involved 

If you do not wish to provide employer details or are unemployed, go to section 4. 

Employer name: 

Employer contact: 

Contact's job title: 

Type of business: 

Your job title: 

Address: 

Telephone: 

Email: 

Employer name: 






4. References 

Please provide the names and addresses of two people who have agreed to provide references. Referees should be able to comment on your 

performance in a working or learning environment, and cannot be friends or family members. 

Name: 

Relationship: 

Address: 

Telephone: 

Email: 

Name: 

Relationship: 

Address: 

Telephone: 

Email: 

5. English language proficiency 

English proficiency test results will be required for all students whose first language is not English, 

or whose primary language of instruction has not been English. Have you taken a recognised English language test? Yes 

If yes, please enter your score in the relevant box below. If no, you can still apply and we will issue you with a conditional offer. 

No 

IELTS 

TOEFL 

Other 

6. Your opinion 

Please explain, in up to 300 words, why you would like to study for this degree, any concerns that you have about studying and how you plan to 

use your degree in your future career. 






7. General questions 

How did you hear about our degree programmes? 

School or college counsellor 

Which school? 

Education exhibition 

Where? 

When? 

University of Essex Online website 

Friend or relative 

Advertisement 

Which publication: 

The British Council 

Somewhere else 

Please specify: 

8. Declaration 

DATA COLLECTION AND PROTECTION 

University of Essex Online degrees are delivered by Kaplan Open Learning. Kaplan Open Learning and the University of Essex are committed to 

a comprehensive policy of equal opportunities for their staff and students, and there is an ongoing programme of action to ensure that this policy 

is fully effective. In order to monitor progress we need to record the relevant information about each student and staff member. Where this 

information indicates that a particular group of students appears to be disproportionately represented in any area of operation, appropriate action 

can be taken. The information we are interested in collecting is on your disability status and ethnic origin. 

Information submitted via this application form will be treated as confidential under the terms of the Data Protection Act 1998. The data will be 

kept secure and accurate and will only be processed for various administrative, academic, and health and safety purposes and as detailed in the 

privacy policy. To enable us to process the data held about you, please sign and date the declaration below. 

I certify that the information I have given is correct and I agree to Kaplan Open Learning and the University of Essex processing personal data in 

connection with my time on the course for any purpose connected with my studies, or my health and safety, or for any other legitimate reason, 

and as detailed in the privacy policy. 

I confirm that the information given in my application form is true, complete and accurate and that no information requested has been omitted. I 

have read, understood, accept and agree to be bound by the terms and conditions and privacy policy. 

I confirm I have read, understood and agree to the declaration above : Yes 

Signature: 

Date: 

9. Final check-list 

Please check you have supplied all the required information and followed this check-list: 

1. Complete all sections of the application form Yes 

2. Confirm you agree to the declaration above Yes 

3. Attach certified copies of academic transcripts and examination results (translated if not in English) Yes 

4. Attach certified copy of your Passport Yes 

5. Send your application and copies of academic transcripts and examination results by: 

Email: admissions@kaplanopenlearning.org.uk 

Fax: +44 (0)113 388 8899 

Post: University of Essex Online 

Admissions Department 

West One 

114 Wellington Street 

Leeds 

LS1 1BA 

We will acknowledge receipt within 48 hours of receiving your documentation.

Application form - University of Essex Online

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