CS Account Application

* denotes a mandatory field

Personal Details

Surname*:

Forenames (at least one required)*:

Preferred Forename:

Title:

Type:

Course Type*:

Degree Course Name:

Supervisor's Name:

UCL Room:

Desk Number:

Phone Extension:

Email*:

UPI:

SN:

Staff Type:

Supervisor's Name:

Research Group (if applicable):

Building:

Room:

Desk:

Phone:

UPI:

Email*: