Oxford Brookes University

Student No. *

First Name *

Known As (if different)

Last Name *

Brookes Email Address *

Personal Email Address *

Mobile

Placement Tutor / Module Leader *

School *

Programme Title *

Student visa holder *

* I have read and agree to the Student Visa Engagement and Attendance Policy

Home Country *

Placement Type *

Are you planning to undertake a placement year? *

Degree Route *

Language *

Second Language *

First Choice University *

Second Choice University *

Third Choice University *

Other

Please explain your reasons for these choices *

* I understand that the information provided here is used as information for the placement tutor for the selection of my university and my preference cannot be guaranteed

* I understand I will be responsible for any expenses relating to the application for my placement abroad. (i.e. Japanese universities may require X-rays, blood tests which could be in the region of £200-£300)

Indicate your work or study placement preference *

You will be responsible for finding your own work placement. Do you have any plans in progress? *

Where are you looking for a placement? *

If you have answered yes to any of the above questions, or have discussed your plans with any OBU members of staff please provide further details. *

Which country/ies are you considering for a study placement? *

Please explain your reasons for this choice *

What is your preferred format? *

Please indicate your preferred study placement format *

Contact Information

Course Details

Registration Form

New Student Registration

Contact Information

Course Details

Registration Form