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Student Life Centre
Welcome
Student Life Centre Enquiry Form
Student Life Centre
Student Life Centre Enquiry Form
<h3 class="wcmform-title">Student Life Centre Enquiry Form</h3> <form class="style1 wcmform" action="" method="post" id="f78FD77DE-70EB-B03C-88B5-73DDD753BC97" enctype="application/x-www-form-urlencoded"> <input type="hidden" name="csrf_token" value="MTYwNjU1MTY2MTg3MzU5OGIwNTM4NDE2NmFlZDA1YzMyNTIxZmVkMmVlMTUxYjNhOGQzNmUyZDlkZjIzZTRhNTBiOTBlYjU2YjE5OThhOTE2ZGIyYjcxMmFl" /> <input type="hidden" name="form" value="78FD77DE-70EB-B03C-88B5-73DDD753BC97" /> <fieldset data-id="fs-0"><legend class="legend show-for-sr">Enquiry Details</legend><h3 aria-hidden="true">Enquiry Details</h3><dl><dt><label class="required" for="ItMrHQUQWu">First Name</label></dt><dd><div class="description">Please enter your preferred name</div><input type="text" name="ItMrHQUQWu" id="ItMrHQUQWu" required="required" /></dd><dt><label class="required" for="rYx4brUwOt">Surname</label></dt><dd><input type="text" name="rYx4brUwOt" id="rYx4brUwOt" required="required" /></dd><dt><label class="" for="pcS6YscBDY">Registration Number</label></dt><dd><div class="description">If you are a current student, please enter your Registration Number which is on your student card and begins 21****** (22****** for students starting in 2020 or later)</div><input type="text" name="pcS6YscBDY" id="pcS6YscBDY" maxlength="8" /><i class="suffix">Maximum of 8 characters. <span></span></i></dd><dt><label class="required" for="cP6zzLnWZD">Email address</label></dt><dd><div class="description">In line with University regulation, the University will contact students through their student email unless otherwise specified in the subject of enquiry box below</div><input type="email" name="cP6zzLnWZD" id="cP6zzLnWZD" required="required" /></dd><dt><label class="" for="d5IPYVNPt4">Previous contact with the Student Life Centre</label></dt><dd><div class="description">If you have been in contact with the Student Life Centre before and would like to contact a specific Student Life Advisor, please write their name</div><input type="text" name="d5IPYVNPt4" id="d5IPYVNPt4" /></dd><dt><label class="required">Subject of Enquiry</label></dt><dd><div class="elementGroupContainer elementRadio"><label><input name="h7WHQe4pVP" type="radio" required="required" value="Academic" /> Academic</label><br /><label><input name="h7WHQe4pVP" type="radio" required="required" value="Exceptional Circumstances" /> Exceptional Circumstances</label><br /><label><input name="h7WHQe4pVP" type="radio" required="required" value="Health" /> Health</label><br /><label><input name="h7WHQe4pVP" type="radio" required="required" value="Personal" /> Personal</label><br /><label><input name="h7WHQe4pVP" type="radio" required="required" value="Progress" /> Progress</label><br /><label><input name="h7WHQe4pVP" type="radio" required="required" value="Withdrawal (Temporary or Permanent)" /> Withdrawal (Temporary or Permanent)</label><br /><label><input name="h7WHQe4pVP" type="radio" required="required" value="Other" /> Other</label><br /></div></dd><dt><label class="required" for="lmp6gPaHJE">Details of Enquiry</label></dt><dd><div class="description">Please write a description of your enquiry, giving as much information as possible to help us answer your questions</div><textarea name="lmp6gPaHJE" id="lmp6gPaHJE" required="required" style="width:98%;height:10em;" class="elementTextarea"></textarea></dd><dt><label class="required">My Information may be shared with other departments if necessary</label></dt><dd><div class="description">All information given to the Student Life Centre will be dealt with confidentially and in line with the Data Protection Act 2018. <br /> <br /> In order to best answer your questions, we may need to share the information contained herewith with other teams at the University. Please tick the necessary box below to confirm whether or not you are happy for this information to be shared with the relevant colleagues.</div><div class="elementGroupContainer elementRadio"><label><input name="0SJNfq9ygL" type="radio" required="required" value="I agree" /> I agree</label><br /><label><input name="0SJNfq9ygL" type="radio" required="required" value="I do not agree" /> I do not agree</label><br /></div></dd><dt><label class="required">Please enter the value shown</label></dt><dd><script src='https://www.google.com/recaptcha/api.js'></script> <div class="g-recaptcha" data-sitekey="6LdjfVMUAAAAANaA5p9irDkHt1R1yzmiSZxFSvqF"></div></dd></dl></fieldset> <input class="button" type="submit" value="Submit" /> </form> <script type="text/javascript"> $(function(){ function bytesToSize(bytes) { var sizes = [' bytes', 'KB', 'MB', 'GB', 'TB']; if (bytes == 0) return 'n/a'; var i = parseInt(Math.floor(Math.log(bytes) / Math.log(1024))); return Math.round(bytes / Math.pow(1024, i), 2) + sizes[i]; 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