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VEP EMS Form A - Course Sign up - Personal & Contact Information and Consent
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* Indicates required question
Email
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Your email
First name
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Your answer
Last Name
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Your answer
Student ID number
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Your answer
Date of Birth
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MM
/
DD
/
YYYY
Mobile number
*
Your answer
If you have a google email account, please provide the email address.
(SHU student: please use your SHU username - username@my.shu.ac.uk)
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Your answer
Course title
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Your answer
Year of study (1st/2nd/3rd, if applicable)
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Your answer
Name of your university
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Sheffield Hallam University, UK
EM Strasbourg, France
Country of origin
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Your answer
First Language
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Your answer
Social media you regularly use for communication, e.g. Skype, Facebook Messenger, WhatsApp etc.
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Your answer
Contact names or phone numbers for the social media listed above
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Your answer
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