Registering as an Estranged Student

This form is a confidential document and will NOT be shared.

Registering as an Estranged Student

This form must be completed by the student and can be done in conjunction with a Student Adviser. This form will not be shared outside of the Student Diversity Team.
Please tick all that apply to your relationship
Please provide a brief history or explanation - this question is optional and if you prefer to leave bank that is fine
Please confirm below that you would like a Student Adviser to contact you for further support

For Administration ONLY (askUS Student Adviser to complete)