Student Record Form

Student Record Form

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Student Record Form

The data collected on this form is used for the following purposes: to record your membership of the College, to enable us to contact your designated person in the event of an emergency, to make any reasonable adjustments that might be required in respect of a disability or long-term health condition. As a Fresher your name will be included in the Annual Record in the lists of all first-year undergraduates and graduates. For more information please refer to our privacy policy.

Step 1 of 8 - Your Details

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Name*
Title First name Surname
Date of birth*
DD slash MM slash YYYY
Email*
Level of study being undertaken*
- Undergraduate
- Postgraduate Taught (MSt/MSc/MPhil/2nd BM/PGT)
- Postgraduate Research (MScRes/DPhil)
Nationality*
Are you already a matriculated member of the University of Oxford? (i.e. have you already been enrolled on a degree course at the University of Oxford?)*
- Yes
- No
Please state the name of the College*
Date of matriculation*
DD slash MM slash YYYY
Please indicate if you agree to have your name included on any publicly displayed results lists.*
- Yes
- No
You can make a change to your preference at any time, but please note that we will not be able to change any lists that have already been released. Please send your request to lincaa@lincoln.ox.ac.uk.

Term Time Contact Information
Term Time Address
Please provide the address if you will live in private accommodation and not in College accommodation.

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Mobile*
Home/Vacation Contact Information
Home/Vacation Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
Mobile*

Emergency Contact Information
We may need to contact your designated person in the event of an emergency. Please provide information about them below.
Name*
Title First name Surname
Relationship to you*
Mobile*
Other phone number (if they have an alternative number)
Email*
Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country
We recommend that all students register with the College Doctor’s Practice (King Edward Street at the Northgate Medical Practice). Will you register with the King Edward Street at the Northgate Medical Practice or another GP in Oxford?*
- King Edward Street at the Northgate Medical Practice
- Another Oxford-based GP (you need to provide the surgery name and address)
GP Surgery Name
Address
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Please confirm that you have completed the following:*
If you have not completed the following, please do so before continuing with this form.
- I have signed my Student College Contract declaration
- I have registered at the King Edward Street at the Northgate Medical Practice or provide my Oxford surgery’s contact details.
- [Undergraduates only] I have completed the University Card form and have provided a photograph
- [Undergraduates only] I have completed the SOLO Library task// I will complete the task before my Library induction session
- [Postgraduates only] I have read the Bursar's letter on fees and charges
- [Postgraduates only] I have watched the Library induction video
- [Postgraduates only] I have uploaded a passport photograph
Please upload the signed declaration for your Student College Contract*
Please attach only the signed declaration, not the whole contract. Please upload this as a PDF.
Accepted file types: pdf, Max. file size: 128 MB.
Please upload the completed University Card form
Please attach only the signed declaration, not the whole contract. Please upload this as a PDF.
Accepted file types: pdf, Max. file size: 128 MB.
Please upload confirmation of your GP Registration at the King Edward Street at the Northgate Medical Practice
Please upload this as a PDF if registering at the King Edward Street at the Northgate Medical Practice for the first time.
Accepted file types: pdf, Max. file size: 128 MB.
Please upload a passport-sized photograph*
Please provide a passport-sized photograph of yourself. This should be a head and shoulders shot against a plain background.
Accepted file types: jpg, jpeg, gif, png, Max. file size: 128 MB.

The data collected on this form is used for registering students and/or for updating your student record file. Your details will only be used by Lincoln College and the University of Oxford and we will never sell or pass your details to other organisations to use for their own purposes.

For more information, please refer to Lincoln College’s Privacy Policy.

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Step 1 of 8 - Your Details

Term Time Contact Information

Home/Vacation Contact Information

Emergency Contact Information

Disability Information

Welfare

Financial and Welfare Survey

Freshers' Dinner