HESA form 2015-2016

The Royal Academy of Music is required to collect annually certain personal information (in codified format) for statistical purposes and
to fulfil HESA (Higher Education Statistics Agency), governmental and other requirements. All information provided is kept in accordance
with the provisions of the Data Protection Act (1998). Some of the questions may duplicate data which you have already supplied to the
Academy, but please complete the entire form anyway. The Registry has extra copies of this Form and the HESA Student Data
Collection Leaflet.

Please return your completed form to the Registry via post or email by 2 SEPTEMBER 2015.
ALL SECTIONS MUST BE COMPLETED

Student ID/Enrolment number: ______________________________________________________________

Surname: ________________________________________________________________________________
Forenames: ______________________________________________________________________________
Surname at age 16, if different to above: ______________________________________________________
Date of birth (day/month/year): _______________________________________________________________
Biological sex:

Male

Female

What is your legal sex:

Male

Female

Other

If you have a Scottish Candidate number, please write it here: ___________________________________

If you have a UK Unique learner number, please write it here: ____________________________________

ADDRESS AND ACCOMMODATION DETAILS:

Permanent address (this is where you return to in the summer):
________________________________________
________________________________________
________________________________________
________________________________________
Town/City: _______________________________
Postcode: ________________________________
Country: _________________________________
Term-time Address:

Please indicate which address type this is:

________________________________________

Accommodation managed by the Royal Academy of Music

________________________________________

Rented accommodation found privately

________________________________________

University of London Hall of Residence

________________________________________

Your parents'/guardians home

Town/City: _______________________________

A home that you own or rent yourself

Postcode: ________________________________

Living with other family or friends in their home

Another form of accommodation

UK Mobile number: _______________________

Please state the cost of renting your accommodation (without bills) for the year 2015/2016:
I will pay

per

week

month

term

year

other

In which country is your permanent home? _________________________________________________

Page 1 of 3

HESA FORM 2015/2016

ALL SECTIONS MUST BE COMPLETED

2. Sexual Orientation Please tick ONE box:

1 Bisexual

2 Gay man

3 Gay woman/lesbian

4 Heterosexual / straight

5 Other ________________

98 Prefer not to say

2 Buddhist

3

10 Hindu

11 Jewish

12 Muslim

13 Sikh

14 Spiritual

01 No religion

80 Other

3. Religion or Belief Please tick ONE box:

Christian

98 Prefer not to say

4. Please state your nationality: _____________________________________________________________
If dual nationality, please write both, UK or EU country first if applicable
5. Ethnic Origin Please tick ONE box
Ethnic origin questions are not about nationality, place of birth or citizenship. They are concerned with broad ethnic groups.
Please tick the box you feel most closely describes your ethnic origin (one box only).
Asian or Asian British
Mixed
White

31 Indian

41 White and Black Caribbean

10 White

32 Pakistani

42 White and Black African

15 Gypsy or Traveller

33 Bangladeshi

43 White and Asian

Black or Black British

34 Chinese

49 Other mixed background

21 Caribbean

39 Other Asian background

22 African

50 Arab

29 Other Black background

98 Prefer not to say

80 Other ethnic origin _____________________________________________________________________
6. Do you have any special needs or medical conditions? Please tick AT LEAST one box

00 No known disability

51 A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D

53 A social/communication impairment such as Aspergers syndrome/other autistic spectrum disorder

54 A long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, asthma or epilepsy

55 A mental health condition, such as depression, schizophrenia or anxiety disorder

56 A physical impairment or mobility issues, such as difficulty using arms or using a wheelchair or crutches

57 Deaf or a serious hearing impairment

58 Blind or a serious visual impairment uncorrected by glasses

96 A disability, impairment or medical condition that is not listed above:
Please specify:

7. If you are a UK national or have settled status in the UK and currently receive the Disabled Student Allowance
(DSA), please tick this box:

Page 2 of 3

HESA FORM 2015/2016

ALL SECTIONS MUST BE COMPLETED

8. Were you ever placed in care?
th

1 In care at the age of 16+

4 In care prior to 16 birthday

5 Was not placed in care

98 Prefer not to say

EDUCATION DETAILS
9. Do any of your parents* have any higher education qualifications, such as a degree, diploma or certificate of
higher education? (* including natural parents, adoptive parents, step-parents or guardians who brought you up)

1 Yes

2 No

8 Dont know

9 Prefer not to say

10. If you are under 21, please give the occupation of your parent, step-parent or guardian who earns the greatest
income. (Please consult the HESA Student Data Collection leaflet to find the correct code).
Job title: ______________________________________

SOC2010 code:

If you are over 21, please tick this box:

11. What is the main source of funding for your tuition fees in 2015/16? Please tick ONE box

Loans

Parents/your own savings

Academy scholarship

Other scholarships/grants

Other: _________________________________________________________________________________
12. What is the highest academic qualification/professional qualification that you have been awarded? (If you are
coming as a year-abroad or exchange student, please tell us the qualification you gained to enter your home institution.)
Subject/Major

Qualification (BA, MA, A-level)

Grade/Mark

Date Awarded

13. What was the school or university you most recently attended?
Full name of the institution: ________________________________________________________________
Date of completion: (MM/YYYY) ______________________________________________________________
Type of institution Please tick ONE box

4901 UK state school

4911 UK independent school

4921 UK Further Education college

4941 UK Higher Education Institution

4931 Any non-UK institution (please specify university, gymnasium, etc): ____________________________

Please return the completed form to the Registry via email or post by 2 SEPTEMBER 2015
Email: registry@ram.ac.uk
Post: The Registry, Royal Academy of Music, Marylebone Road, London, NW1 5HT, UK

Page 3 of 3