Tier 4 (General) Tier 4 Student April 2013 This printed application is for informational purposes only. Please do not send a copy of this application by post, as your official application is submitted online to the UK Visas and Immigration. Customise application Student In Country Customisation Are you applying from within the UK? What are you applying for? Are you eligible to bring dependants with you? Are any of your dependants included in this application? Is a representative acting for you in relation to this application? Who is completing this application? Do you have a BRP? Which age group do you belong to? Tier 4 (General) I am 18 and over Lead applicant Personal details Your personal details Name as given in your passport or travel document Title Family name Given names Gender Relationship status Miss Smith Susan Female Single Date of birth 2 vember 1990 Village, town or city of birth Country of birth Nationality Beijing Tell us which other nationalities you currently hold Do you hold any other nationality? Form Version: 6.1, Builder Version: 8.4.9 20/06/2014 09:31:28 Page 1 of 7
Tell us which previous nationalities you have held Have you held any previous nationality? Other names that you are known by Are you currently known by any other name? Previous names you have been known by Have you ever used or been known by another name? Contact details in the UK Where are you currently living? Address House number or name Flat 1 Student Hall of Residence Manchester When did you move to this address? 30 June 2014 Your contact details Landline telephone number Mobile telephone number 07974644258 Work telephone number Preferred contact number Fax number Email address Mobile yourname@manchester.ac.uk Correspondence address Is this also your correspondence address? What is your correspondence address? House number or name Gerry Bell, Student Services Centre Burlington Street, University of Manchester Oxford Road, Manchester Reference numbers Form Version: 6.1, Builder Version: 8.4.9 20/06/2014 09:31:28 Page 2 of 7
Tell us about the reference numbers that have been assigned to you Have you ever had any UK Visas and Immigration reference numbers assigned to you? Do you know this number? Your UK Visas and Immigration reference number Do you have a National Insurance number? Have you previously had a National Insurance number? VAF NUMBER ON VISA Passport or travel document Your passport details Can you provide a current passport or travel document with your application? Is the passport or travel document in your name? Passport or travel document Passport or travel document number Country of issue Nationality G1234567 Dates of issue and expiry From 1 January 2009 To 31 December 2018 Issuing authority Have you ever had any other passport or travel document that you have used to travel to the UK? M&P EXIT AND ADMINISTRATION Previous addresses Please give details of your previous addresses in rthern Ireland and the dates you lived there Have you previously lived in rthern Ireland? Your previous address details Have you lived at any other address in the UK within the past 5 years? Your previous address details Form Version: 6.1, Builder Version: 8.4.9 20/06/2014 09:31:28 Page 3 of 7
Address House number or name IF YOU MOVE AGAIN AFTER YOUR PRE-SESSIONAL COURSE, YOU WILL NEED TO UPDATE THIS SECTION When did you live at this address? From 30 June 2014 To 12 September 2014 Personal history Personal history Have you been convicted of any criminal offence in the UK or any other country? Do you have any civil judgments against you or any civil penalty under the UK Immigration Acts? Have you ever been charged or indicted in any country with a criminal offence for which you have not yet been tried in court? In either peace or war time have you ever been involved in, or suspected of involvement in, war crimes, crimes against humanity, or genocide? Have you ever been involved in, supported or encouraged terrorist activities in any country? Have you ever been a member of, or given support to, an organisation which has been concerned in terrorism? Have you, by any means or medium, expressed views that justify or glorify terrorist violence or that may encourage others to commit terrorist or other serious criminal acts? PBS immigration history Current immigration status What is your current immigration status in the UK? I have leave to enter / remain for a limited period Leave Category What category of leave (permission to stay) do you have? Were you required to register with the police as a condition of this leave? As a Tier 4 (General) Student Entry clearance/visa Did you have a visa/entry clearance when you last applied to come to the UK? In which country did you obtain that visa/entry clearance? What is the reference number for that visa /entry clearance (this can be found in your passport/travel document)? 123456 Date visa/entry clearance valid from 20 June 2014 Form Version: 6.1, Builder Version: 8.4.9 20/06/2014 09:31:28 Page 4 of 7
Date current leave expires 5 October 2014 Previous leave in the UK Have you ever stayed in the United Kingdom beyond your period of leave? Have you ever knowingly used deception when seeking leave to enter or remain, entered the United Kingdom illegally or worked in the United Kingdom without immigration permission to do so (contrary to your conditions of stay)? Have you ever been refused entry clearance, leave to enter or leave to remain in the UK? Have you ever been removed, required to leave or deported from the UK? Outstanding applications Do you currently have any other applications with UK Visas and Immigration on which you are awaiting a decision? Outstanding appeals Do you currently have an immigration appeal before the Tribunal which has not yet been determined? Public funds Public funds Have you ever claimed any public funds? T4 course details T4 sponsor details Sponsor's licence number Sponsor name Is this correct? Q3DK76WN4 University of Manchester Sponsor's address House number or name UNIVERSITY OF MANCHESTER OXFORD ROAD MANCHESTER T4 course details Do you have a CAS? CAS number What is the level of qualification you will be awarded when you successfully complete your course? Title of your course of study NQF7 / SCQF11 WRITE COURSE TITLE AS ON YOUR OFFER LETTER OR CAS Form Version: 6.1, Builder Version: 8.4.9 20/06/2014 09:31:28 Page 5 of 7
Date the course starts 15 September 2014 Date the course ends 30 September 2015 Is the address of your primary site of study the same as your Tier 4 sponsor's address? T4 UCAS details Is your sponsor a Higher Education Institution? Did you apply for your course through UCAS? How can you demonstrate your English language ability? Maintenance (funds) My CAS confirms I speak, listen, read and write in English to B2 level Maintenance (funds) How much are your course fees as stated on your Confirmation of Acceptance of Studies (CAS), in pounds sterling? Have you or your parent(s)/legal guardian(s) already paid any of your course fees? 12400 How much has been paid? 4133 What evidence are you providing with your application that this amount has been paid? Do you have current leave as a Tier 4 Student, as a Student or as a Postgraduate Doctor or Dentist? Have you, during your current period of Tier 4 leave: How long was the course you completed, or if you are still studying, how much of your current course have you completed to date? Where are you intending to study? Have you or your parent(s)/legal guardian(s) already paid any money to your sponsor for accommodation? Information on the CAS Started and completed the course of study for which your current leave was granted? Less than 6 months Outer London or anywhere else in the United Kingdom How much has been paid? 1020 What evidence are you providing with your application to show that this amount has been paid? Are you receiving money from an official financial sponsor? Are all of the funds in your name? Information on the CAS T4 general attributes T4 general attributes What is the level of the course you are applying for? Do you need to obtain permission from the Academic Technology Approval Scheme (ATAS)? Are you being sponsored by a government or international scholarship agency - or have you been sponsored by one of these bodies within the past 12 months? Supporting documents NQF8 / SCQF12 Form Version: 6.1, Builder Version: 8.4.9 20/06/2014 09:31:28 Page 6 of 7
This section has intentionally been left blank. When you have checked your application online your supporting documents will be displayed Declaration This section has intentionally been left blank. When you have checked your application online your declarations will be displayed Form Version: 6.1, Builder Version: 8.4.9 20/06/2014 09:31:28 Page 7 of 7