INTERNATIONAL STUDENT APPLICATION FORM
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1 OFFICE USE ONLY Student ID: Direct Other, please state INTERNATIONAL STUDENT APPLICATION FORM Course(s) applying for: Mode of attendance: Part-time Full-time Desired start date: 1. Personal details (Mr/Mrs/Miss/Dr) Surname / family name (as appears on passport) First name (as appears on passport) Previous surname / family name (if changed) Gender Male Female Permanent home address in home country Date of birth (DD, MM, YYYY) Contact details in home country Mobile (inc. country code) Landline (inc. country code) UK address (if already resident in the UK) Contact details in UK (if applicable) Mobile Landline 2. Immigration, fees and residency 2. Immigration, fees and residency Passport number List dates of arrival and departure in the UK Passport issue date Passport expiry date Nationality Have you previously lived/studied in the UK? If you are currently studying in the UK please provide name and address of current institution below Who will be paying your fees? Have you ever had a UK visa? Type of last/current visa (if applicable) UK Visa number Visa issue date Visa expiry date Failure to declare may affect your application Have you ever had a visa refused for entry to the UK? 3. English level
2 3. English level Examining body (IELTS, TOFEL, Pearson etc.) Score Date issued Expiry date 4. Where did you hear about Bucks? Please only tick one box Agent (please complete contact details below and provide agent stamp if applicable) College/University outside of UK (please complete contact details below) College/University in UK (please complete contact details below) Friend/Family Current or Alumni Bucks student (please complete contact details below) Other, please state Agent or College name Telephone 5. Ethnicity Please tick the box which most closely describes your ethnic origin White (11) British (12) Irish (19) Other white background Asian or Asian British (31) Indian (32) Pakistani (33) Bangladeshi (34) Chinese (39) Other Asian background Black or Black British (21) Caribbean (22) African (29) Other black background Middle Eastern Mixed (41) White & Black Caribbean (42) White & Black African (43) White & Asian (49) Other mixed background (80) Other ethnic background (98) Information refused 6. Disability (01) Dyslexia (02) Blind/partially sighted (03) Deaf/hearing impaired (04) Wheelchair user/ Mobility issues (05) Personal support needed (6) Mental health difficulties (07) Unseen disability (08) Multiple disabilities (09) Disability not listed above, please specify ne 7. Criminal convictions Do you have any criminal convictions? Tick as appropriate. If yes please give details and dates
3 7. Current and previous education and qualifications Continue on additional sheets if required 8. Current and previous education and qualifications Continue on additional sheets if required It is a requirement of the UKBA that Bucks is aware of all of the study you have completed and attempted to complete from the age of 16, whether that was in your home country, the UK or elsewhere. Please list all of your education below, including your current course of study if enrolled. Gaps in your education history or missing documents may result in your application being delayed or declined and could result in a visa refusal. Start and end date of course Course title, including awarding body Grade Course level/ NQF level Institution where course was studied where course was studied Final certificate/ transcript enclosed? Copy of UK visa enclosed?
4 9. Current and previous employment Name and address of company Job title and description Start date End date 10. Personal statement/statement of purpose Continue on additional sheets if required Please continue on a separate sheet of paper. Your statement should be approximately one A4 page in length and include information such as: Skills, interests and hobbies Why you want to study in the UK and at Bucks New University Why you chose this course and your career plans 11. References (If required, please refer to guidance notes) Name Name Postcode Phone inc country code Postcode Phone inc country code
5 12. Declaration I confirm that, to the best of my knowledge, the information given is correct and complete. I have read the instructions, in particular those relating to this section. I understand what it says and I agree to abide by the conditions set out there, which I accept as a condition of application. I agree that Bucks New University can process my information for my application and internal research. I am fully aware of and can meet the financial requirements set out by UKBA to achieve 10 points for my visa and can ensure I can pay tuition fees and support myself financially I fully understand the terms and conditions linked to the Tier 4 student visa. Signed: Date: Checklist, please tick when complete Completed and signed application form Personal statement / statement of purpose completed Copy of valid passport (enclosed or attached by ) Copy of all UK visas (if applicable) enclosed or attached by Final certificate for qualifications listed (if available at time of application) enclosed or attached by Transcripts for qualifications listed (if available at time of application) enclosed or attached by References (if required, refer to guidance notes) completed Copy of IELTS certificate or equivalent (if available at time of application) enclosed or attached by Work experience evidence for MBA, Nursing and Social Work applicants (enclosed or attached by ) Copy of all CAS and visa related paperwork issued to you by UKBA or the Home Office Submission of application Bucks New University Queen Alexandra Road High Wycombe Bucks HP11 2JZ : internationaloffice@bucks.ac.uk Telephone: Please note that incomplete application forms and missing documents will not be processed. Failure to disclose requested information such as previous visas and study in the UK may result in your application being declined. Version 6 - August 2014
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