Form of Authority Student Advice Centre

Fields with an asterisk (*) are required.

I hereby authorise, on my behalf, Staffordshire University Students' Union Student Advice Centre to:

*Contact: 

*Act in the matter of:


Contact Details

*Student Number: 

*Title:

*Full Name: 

*House Number & Road: 

District: 

*Town: 

*County: 

*Post Code: 

*Country: 

*Today's Date: 

 *I confirm and agree to the above.