UCE Union of Students


				Good Morning Sat, 13 October 2007

Registration Form

About you:

Step 1

The Data Protection Act 1998 - The Students’ Union needs to process data about you in order to get a better understanding of the profile and needs of our membership. That is we collect, store, use and disclose the data for any purpose connected with your membership of UCE Union of Students, your health and safety and other legitimate reasons such as complying with our statutory obligations under the Disability Discrimination Act 1995 , Race Relations (Amendment) Act 2000 and the Special Educational Needs And Disability Act 2001.When you register with the Union you will be giving us permission to process data about you. Southern comfort cabin rentals in Blue Ridge, GA.

When you register we ask you to give Emergency Contact details (Step 6). This data will be used or disclosed only in case of an emergency. Please note that you are responsible for ensuring that the emergency contact is notified of the disclosure of their details to UCE Birmingham Students’ Union.

Click here for more information on the Terms and Conditions and Privacy Policy.

First name	Initial
Last name
Gender
Date of birth	medical kit and car emergency kit. A emt bag
Nationality

Course Info:

Step 2

Now enter your course and graduation details. This information will be used to allow your Student Rep to contact you about any issues you may have with your course.

UCE Students (If you are not a student at UCE, please complete the next part of this section.)

Faculty
Course Title
Mode of Study
What year did you start at UCE?
Current Year of Study
Graduation
What campus do you mainly study at?
Are you on a placement this year?	Yes &nbspNo

Non UCE Students
Please tell us here how you are associated with UCE Birmingham Students’ Union.
Association

Membership details:

Step 3

User name needs to be completed unique to you otherwise you may incur problems in completing your registration.

Username

Password

Re-type

Student ID Number (On Library Card)

Security

If you forget your username/password, you can still gain access to your account by answering a security question. Use the menu below, choose a question that would be difficult for someone else to guess - or choose your own question.

Security Question
Other
Answer	(minimum of 4 chars)

e-Mail & Mobile:

Step 4

To receive important emails and text messages please let us know your details below.

e-Mail
Re-type e-Mail
Mobile no
Re-type Mobile no
If you have web-based email which you would like to access from here, please give the web address or choose from the list below.
Choose a provider
-- Or --
Type your web-mail address here

Postal Address:

Step 5

So we can contact you by post please provide your term-time address and a permanent address if different for outside the term dates.
In term time you are living	At home (i.e. with parents, relatives etc) In rented accommodation In University Accommodation/Halls In your own home Other
Term-Time Address:
Room and/or House/Flat Number and/or Building/House Name
Halls (if applicable)
Street (or halls name)
Area
City/Town
County
Post Code
Country
Telephone

Permanent Address (Parents house, etc.):
Building/House name
Street
Area
City/Town
County
Post Code
Country
Telephone

Emergency Contact and other information:

Step 6

So we can contact someone for you in the event of an emergency, please give the name and address of your partner/spouse/family member.

Their name

Their daytime phone number

Their evening phone number

Their mobile number

The remaining questions in this section are optional; information you give will help us in achieving equality of opportunity and participation for all our members and helps us to monitor our aim to have an inclusive, active and diverse student membership. Since the information is only collected for monitoring purposes, it is only disclosed in a form which guarantees your anonymity. It also helps ensure we comply with the Race Relations (Amendment) Act 2000 and the Disability Discrimination Act 1995.
How would you describe your ethnic origin
-- Or --
Other ethnic group
Sexuality
Do you belong to a religion? If so, please state which.

Do you have any registered or un-registered medical condition, disability or learning support need? If yes, please state.
Do you have a requirement for childcare facilities?	Yes No Not disclosing
Do you have children under 18 years of age?	Yes No Not disclosing
Do you have any other caring responsibilities?	Yes No Not disclosing
Do you expect to take paid employment during term time?	Yes No Not disclosing
Are you the first person in your family to have attended a higher education institution?	Yes No Not disclosing

I'm Interested in...

Step 7

Would you like to receive any information on the following?

Union general

Health Issues	Improving the quality of your course	NUS News
The Advice Centre	Union Bars/Ents	Union News
Union Shops

Union Activities:
Give it a go	Key Training Skills	Running the Union
SCRatch (radio station)	Spaghetti Junction (magazine)	Sports Clubs
Trips	UCE student TV	Volunteering in the community
Volunteering in the Union	Working in the Union	www.uceunion.com

Union Societies within the following categories:
Academic	Campaigning	Charities and Action
Cultural	DJing	Film and Media
Food and Beverage	Games	Performance
Religious	Welfare

New Union sports:
Athletics	Boxing	Chess
Cross Country Running	Cycling	Golf
Judo	Pool	Snooker
Squash	Table Tennis	Taekwondo
Tennis	Tenpin Bowling

If you get involved in the Union you may be able to drive your fellow students to activities/events. Please check the box if you have:
2 years driving experience	A full clean UK driving licence	Your own transport

University:
Alumni	Careers	Health Centre
Job Shop	University News

Are you interested in receiving information on the following liberation campaigns?
Lesbian, Gay or Bisexual: Fighting for a world free from discrimination for Lesbian, Gay and Bisexual people by challenging attitudes and stigmas through education
Students with Disabilities: Challenging the stigma of disabilities, fighting for equal human civil rights and equal access in all areas of SWD life.
Womens' Liberation: Working to combat sexism in all of its forms and to ensure that womens' voices are heard and valued.

Which of the following music interests you:
Bangra	Chart	Cheese
Dance	Drum & Bass	Funky House
Garage	Hip Hop	House/Trance
Indie/Alternative	Jazz/Classical	Other Music
Pop	Retro	RnB
Rock	Salsa/Latin	World Music

Going out:
Cinema	Comedy/Cabaret	Live Music/Band Nights
Museums	Opera/Musicals	Performance Dance
Sporting events	Theatre	Visual Arts

Big Wide World:
Insurance	Sport	Student Discounts
Travelling

Join:

Step 8

I accept the Terms & Conditions.

I do not accept the Terms & Conditions.

Only click this button ONCE --><--Only click this button ONCE

By clicking on the 'Sign Me Up' button you are agreeing to our Terms & Conditions.

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