Sanctuary Scholarship Application Form

Transcription

1 Sanctuary Scholarship Application Form Section 1: Personal Details We will use the information provided in this section to contact you about your application. Please ensure that you include your name as you would wish to see it on, for example, a certificate. 1.1 Title (e.g. Mr, Mrs, Miss, Dr, Mx, etc) 1.2 First name/given name 1.3 Last name/surname 1.4 University ID Number/Student Number (if applicable) If you know these details then add them to the form. If not, then write unknown to enable you to progress with the application. 1.5 Correspondence address 1.6 Home address (if different from above) 1.7 Contact telephone number Please provide the number on which you can most easily be contacted (e.g. landline or mobile) address 1.9 Date of birth 1.10 Nationality

2 1.11 Gender (please select) Male Female Prefer not to say Other 1.12 Do you consider yourself to have a disability? No Prefer not to say Yes (please give details below) Section 2: Educational details 2.1 Please select your intended level of study Pre-sessional Foundation Postgraduate research PhD Inter-sessional Undergraduate Postgraduate taught 2.2 What course would you like to study? 2.3 Have you received a conditional or unconditional offer? If you have a conditional offer please specify the conditions below 2.4 If you have previously studied higher education elsewhere in the UK, or overseas, Please indicate how many years of study you have previously undertaken. One Two Three Four Five I have not previously studied in higher education before Other (please give details below)

3 Section 3: Eligibility for the Sanctuary Scholarship We will use your answers in this section to help determine whether you meet the advertised eligibility criteria for the Sanctuary Scholarship in relation to your current immigration status in the UK. 3.1 What was your date of arrival in the UK? (dd/mm/yyyy). 3.2 Please select the category which best describes your immigration status in the UK a) I have been granted refugee status AND Indefinite Leave to Remain (ILR). b) I have been granted five years limited leave as a refugee, and intend to apply for Indefinite Leave to Remain (ILR). c) I have been granted Humanitarian Protection (HP) AND Indefinite Leave to Remain (ILR). d) I have been granted Humanitarian Protection (HP) for an initial period of five years limited leave, and intend to apply for Indefinite Leave to Remain (ILR). e) I have been granted Discretionary Leave to Remain (DLR) OR Limited Leave to Remain f) I am awaiting a decision on my application for asylum OR I am in the appeals process. g) My application for refugee status has been finally determined as refused OR I am submitting a fresh claim or applying for judicial review. h) I am the family member of one of the above and my application is dependent on theirs/my leave has been granted in line with theirs. 3. If you have selected option H above, please indicate which of the categories A to G applies to your family member. If you have not selected option H above, then please type Not applicable below. Section 4: Support We would like to know if there are any additional support needs you may have with regards to your personal circumstances. Please be assured that any information you provide in this section will not negatively affect your application in any way. We only request this information so we can help and support you should you be successful in your application. 4.1 Family/household details. Please describe your living circumstances. Living with parents Living with other family Section 95 NASS accommodation Living alone Living in halls of residence Section 4 NASS accommodation Living with friends Living with partner/spouse 4.2 Will your term time living arrangements be described as above? Yes No (please specify your expected living arrangements during term time below)

4 4.3 Will you require student accommodation in order to take up the scholarship if offered? Yes, I intend to apply/have already applied for University -allocated accommodation No I will not be making an application for University-allocated accommodation 4.4 Do you expect you will require any English language support at the University? If so, please provide brief details. 4.5 Is there any additional support other than financial and language support you may need to help you to succeed at the University? (e.g. support for a disability or learning difficulty, counselling, mental health support etc). Section 5: Personal Statement for the Sanctuary Scholarship 5.1 Rationale for higher education What are your ambitions for the future, and how would the Sanctuary Scholarship help you to achieve these ambitions?

5 5.2 Interruptions to prior education How has your education been affected by your personal circumstances? Please outline the particular barriers you have faced in continuing your education, and provide details of any steps you have taken to try to overcome these barriers. 5.3 Immigration status Please provide details of your current immigration status in the UK. 5.4 Scholarship and support needs Please briefly outline your financial circumstances. If you have attended school/college since coming to the UK, how have you supported your studies? Do you have any plans other than this scholarship for supporting yourself financially while at the University?

6 Section 6: Referee Details 6.1 Referee s full name 6.2 Referee s relationship to the applicant 6.3 Name of organisation referee works for 6.4 Role in organisation 6.5 Please attach a completed reference letter from your referee along with your application. Your reference letter must be on letter headed paper and signed by your referee. Please see guidance notes for further details of what is required from a reference.

7 Section 7: Declaration All decisions by the University are taken in good faith on the basis of the statements made on your Scholarship application and your course/programme admissions application, and having considered the referee s supporting statement. If the University discovers that you have made a false statement or have omitted significant information from your application form, for example, regarding your qualifications, the University may terminate your application. Please scan and e mail your supporting evidence to: For institutional use only: Alternatively, you can post any evidence to: For institutional use only: The deadline for all evidence to reach the University: For institutional use only: Incomplete applications will not be considered. Please check all the boxes to confirm you have read and agree to the statements below (check all that apply). I acknowledge that this is a competitive process and that submitting an application for the Sanctuary Scholarship does not guarantee it will be successful. I confirm that I have read the eligibility criterial and that I am eligible to apply for this scholarship award. I agree that, if I am accepted, I will notify the University immediately if my circumstances change before or during my course or programme of study, in particular in respect to my immigration status. I have completed all the required sections in this application form. I will supply copies of any qualification documents I have available to support my application. I will supply copies of Home Office letters and other documentation confirming my current immigration status in the UK. I confirm that the information given in this form is true, complete and accurate, and that no information requested or other material information has been omitted. I confirm that I have attached a signed reference. I consent to the processing of my data by the University for the purpose of dealing with this application. I confirm I have read and agree to the above declaration. The submission of this application constitutes my personal certification that the details are correct. Please enter your name below to confirm this. Your signature Date