Short Study Experience Application Form

Transcription

1 Short Study Experience Application Form Please complete this form in full and return via , along with all supporting documents, to Office Use Only - Date Received: Student ID: General Information Title (Mr, Miss, Mrs, other) Surname First Name(s) Previous Surname Permanent Address Date of Birth (dd/mm/yy) Gender Nationality Country of Birth If not the UK: Date you first arrived (or plan to arrive) in the UK: UK Address (if different from above) Do you require a visa to work or study in the UK? If you are currently in the UK on a visa, please list the details below: Visa Type Expiry date Mobile Phone number UK Mobile Number (If different from above) Emergency contact details Name of Emergency Contact Relationship to you Address Have you previously applied for a visa to study in the UK? Please list details of all applications, including those which where unsuccessful, on a separate sheet. Do you have any criminal convictions? If you would like to authorise another person to discuss your application with UCFB, please provide their details below: Name of authorised person Relationship to you Telephone

2 Current Educational Details Home school or University Exact name of Degree Programme (e.g. BA Economics) Expected Month and year of Graduation Year of study while abroad: 1st/2nd/3rd/4th/Graduate Current average or GPA Is English your first language? Yes No If we assess that English is not your first language you will be required to provide proof of English language level. Ethnicity Please enter the number which best describes your ethnicity. 10 White 13 White - Scottish 14 Irish Traveller 15 Gypsy or Traveller 19 Other White background 21 Black or Black British - Caribbean 22 Black or Black British - African 29 Other Black background 31 Asian or Asian British - Indian 32 Asian or Asian British - Pakistani 33 Asian or Asian British - Bangladeshi 34 Chinese 39 Other Asian background 41 Mixed - White and Black Caribbean 42 Mixed - White and Black African 43 Mixed - White and Asian 49 Other mixed background 50 Arab 80 Other ethnic background 90 Not known 98 Information refused Disability If you have a disability, please enter the number which best applies to you. 08 Two or more impairments and/or disabling medical conditions 51 A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D 52 General learning disability (such as Down s syndrome) 53 A social/communication impairment such as Asperger s syndrome/other autistic spectrum disorder 54 A long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy 55 A mental health condition, such as depression, schizophrenia or anxiety disorder 56 A physical impairment or mobility issues, such as difficulty using arms or using a wheelchair or crutches 57 Deaf or serious hearing impairment 58 Blind or a serious visual impairment uncorrected by glasses 96 A disability, impairment or medical condition that is not listed above 97 Information refused If you have listed a disability, please provide details of any additional support you may need during your studies.

3 Programme Selection Please select your programme(s) and complete any relevant information as requested. For semester programmes please choose the semester you are applying for and the modules you wish to study in Section A. For summer programmes please go directly to Section B Section A: Semester Programme Semester 1 (Sept Jan) Semester 2 (Jan May) Academic Year Semester programme module choices: Please read the following information carefully before selecting your module choices. All students are required to take 2 modules for a total of 60 UK credits per semester. Module change requests can be made up to 2 weeks prior to the semester start date. No changes will be allowed after this time. It is the student s responsibility to ensure that modules are approved for credit transfer by their home university or college in advance. Please note that it is not possible to choose specific day or time slots for modules as these will be allocated automatically by the timetabling system. Teaching takes place at UCFB Wembley from Monday to Friday between 9am and 5pm. Applications will not be accepted without a complete module choice form. By ticking this box you acknowledge that you have read the rules relating to module selection Select your modules. Please enter your top 2 module choices in boxes 1 and 2 of the table below, listed in order of preference. Please also list 2 alternative choices in boxes 3 and 4. These will be used in case we are unable to register you on your first choices due to timetable clashes, course closure etc Module options vary according to the semester. Please ensure you choose modules that are offered during the semester that you are applying to. The full list for each semester can be viewed on the UCFB website here: Module code Module Title For office use only Section B: Summer Programmes International Strategic Leadership and Management Programme Pre-University Programme: UCFB Certificate in Sport Management If you are applying to the Pre-University Programme please ensure that you complete the Disclaimer for Minor Students which can be downloaded from the UCFB website. Session l Session ll

4 Visa Requirement Nationals from within the European Economic Area do not require visa entry clearance to study in the UK. Nationals from outside the EEA do require visa entry clearance Short-term Study Visa (less than 6 months) or Tier 4 Student Visa (6 months or more) Please indicate which of the following applies to you: A. National of a country within the European Economic Area (EEA) or Switzerland B. Citizen or national of a country outside the EEA (eg. USA, Japan, Korea, China, India etc) If you have answered A No visa/entry clearance required If you have answered B You may need to apply for the appropriate visa for the duration of your studies. Please ensure you check requirements on It is the student s responsibility to ensure that they have the legal right to enter the UK. Visa applications should not be made until you receive an official offer from UCFB Accommodation Accommodation is included in the following programmes: n International Strategic Leadership and Management Programme n Pre-University: UCFB Certificate in Sport Management For other programmes, accommodation is not included however can be arranged through our partner Halls of Residence. Please see the UCFB website for more details including fees. Please note that while UCFB is happy to facilitate accommodation arrangements, UCFB will not be involved in any contractual obligations which are solely between the student and the accommodation provider. Please tick one of the following accommodation options: Included in programme Halls of Residence* I will be making independent housing arrangements Please complete the separate housing form which can be downloaded from the UCFB website and return together with your application. If you wish to be housed with a specific person(s), please list their name(s) here. Please note that requests for roommates must be mutual in order to be accommodated. Please tick one option only Where did you hear about UCFB? Advert Google Search Social Media School/College Adviser Friends/Family Other

5 Check List Please ensure that you have the following documents ready before submitting your application: A copy of the application from with ALL required fields completed Official transcripts of all previous study A copy of the main photograph page from your passport Please note that your passport must be valid for at least 6 months after your arrival in the UK. If you do not yet have a passport, please ensure a copy is sent to UCFB at least 2 weeks prior to your arrival in the UK) Proof of English language proficiency (if English is not your first language). Please see individual programme entry requirements Personal statement please enclose a short personal statement ( words) on a separate sheet of paper explaining your motivations for applying to a UCFB short study experience. Housing form, only if applying for optional Halls of Residence Minor Disclaimer form, for pre-university programme applications only Student Declaration I declare that to the best of my knowledge, all information contained in this form (and any additional documents submitted) are correct and complete. I authorise UCFB to process, store and review all information submitted as part of the application process. I will inform UCFB of any changes to my personal circumstances which may affect my application to study on this programme. I have read and accept the UCFB Short Study Experience Terms and Conditions. If completing this form electronically, please type your name and the date in the below box. Signed Date