Student Ambassador Application Form – September 2023 UG Open Days

Personal Details:
Family Name: First Name:	Gender: Mobile Number:
University Email Address:	Student Number: (On library card) Payroll Number:
Student status: UK EU International (Please circle/delete as appropriate) Nationality: Are you a Tier 4 visa holder? YES NO (Please circle/delete as appropriate) N.B. Please note that if you are studying in the UK on a Tier 4 student visa, you will only be allowed to work a maximum of 20 hours per week.	Languages: First language: Additional languages: Any other languages spoken and level:

University course details: Undergraduate Postgraduate Full-time Part-time Department: Course title: Year of planned Graduation:
Relevant information required for Open Day roles: Have you lived on campus, either currently or previously? YES NO (Please circle/delete as appropriate) If yes, please state which accommodation you stayed in: Are you a member of any clubs or societies on campus? If so, which ones:
Convictions: Have you ever been convicted of any criminal offence? If yes, please give details. Yes No Are you a person known to any social services department as being an actual or potential risk to children? If yes, please give details. Yes No
Data Protection and Declaration This information will be held and processed for the selection of appropriate applicants for work and the need to contact selected student staff when necessary. I agree to the University recording and processing this information about me. I understand that this information will be used only for the purpose(s) set out in the statement above, and my consent is conditional upon the University complying with its duties and obligations under the Data Protection Act. I declare that, to the best of knowledge, the information given is true and correct. Print name: Date:

Thank you very much for providing the information.

Please submit the completed application to

gg213@bath.ac.uk by Friday 21 July 2023.