University of Sunderland Study Abroad and Exchange Application Form (Undergraduate only)

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University of Sunderland Study Abroad and Exchange Application Form (Undergraduate only) THIS FORM SHOULD BE TYPED AND THEN PRINTED OR EMAILED DIRECTLY TO STUDY.ABROAD@SUNDERLAND.AC.UK ALONG WITH ALL SUPPORTING DOCUMENTATION see checklist at end of this application. Please complete all of the application form in full, otherwise we will not be able to process your application. 1. Personal Details Family Name: Forename(s): Title: Mr/Miss/Ms/Mrs/ Other Gender: Male Female Date of Birth: (dd/mm/yy) / / Nationality: Country of Birth: Country of Residence: Address for correspondence: Country: Telephone No: Postcode: Email: 2. Proposed Details of Study Year of Entry: 2016/2017 Semester: Semester 1 only (Sep Jan) 2017/2018 Semester 2 only (Jan June) I am applying as: Exchange student Study Abroad student Full Year (Sep June) 3. Home University Details Home University: Major Subject(s) of study at home university: Name of Study Abroad Advisor at your home university: Email address of Study Abroad Adviser:

4. Student Support Information Do you consider yourself to have a disability or medical condition? Yes No Prefer not to say If Yes please give details about your disability/medical condition and any daily living and/or learning supports that you currently receive: You do not have to provide this information but if you do not it may mean that you will find it difficult to subsequently comply with the requirements of your programme and enjoy the full benefit of your study abroad. If you have a disability or medical condition we do urge you to disclose this now in order that we can determine if your support needs can be met, which is conducive to a productive and positive experience when living and studying abroad. Do you have any criminal convictions? Yes If Yes, please provide details: No Do you intend to bring dependents with you? Yes No If Yes, please provide details: Please note that this form is used within the University for internal purposes only but may be shared between relevant departments. If you have any queries about how the University uses your personal data please contact Data Protection Officer, 4 th Floor Edinburgh Building, City Campus, Chester Road, Sunderland SR1 3SD or Dataprotection@sunderland.ac.uk.

5. Tuition Fees Who will be responsible for paying your tuition fees to the University of Sunderland? I am applying as an Exchange student, so I have a fee-waiver OR My fees will be paid by: Myself Family Member ISEP Home University Sponsor Employer Other (please state) 6. English Language Please provide details of any evidence of your English Language ability and enclose photocopies of certificates or other evidence (only if English is not your first language) Non-EU citizen please provide an IELTS certificate in order to comply with UKVI regulations EU Citizen - please state the name of the test or examination taken and the result obtained:

Full Name: 7. Study Abroad and Exchange Programme Learning Agreement Form You must complete this form in full so that we can assign modules to you before you arrive in Sunderland. Home University: Duration of stay: Semester 1 (60 credits) Full Year (120 credits) Semester 2 (60 credits) Please mark with an * the modules that you MUST complete for your home university s requirements. It is your responsibility to ensure that the modules you list on this form will be accepted by your home university. This form must be signed by you (the applicant) and an academic/study abroad adviser at your home university. Please list your modules in order of preference, 1 being your first choice, 2 being your second choice etc. We cannot guarantee that classes you have chosen will be available. You should have 60 Sunderland credits per semester for your time in Sunderland (this is equivalent to 30 ECTS credits per semester) You can find the available modules at www.sunderland.ac.uk/studyabroad FIRST CHOICE MODULES (please complete all sections in full) Module Code Module Title Credits Semester (1, 2 or FY) 1. 2. 3. 4. 5. 6. ALTERNATIVE MODULE CHOICES (please complete all sections in full) Module Code Module Title Credits Semester (1, 2 or FY) 1. 2. 3. 4. 5. 6. Please note that you will be contacted by an academic advisor before your arrival in Sunderland to discuss your module choices. You do not enrol for classes before you arrive. Signed by the applicant Signed by academic/study abroad adviser Date Name Position Date

8. Personal Statement Please provide a brief statement outlining why you wish to study at the University of Sunderland on the Study Abroad or Exchange Programme. (Continue on an additional sheet if necessary)

9: Visa Information If you are an EU Citizen, no visa is required. Please tick here if you are an EU Citizen If you are a non-eu citizen you can check visa requirements at the UKVI website: https://www.gov.uk/check-uk-visa Please let us know which type of visa you intend to apply for. Please note that if you are applying to Sunderland for 1 semester we recommend a Short Term Study Visa (full details at https://www.gov.uk/study-visit-visa/overview). Citizens of many countries can apply for a Short Term Study Visa on port of entry to the UK. Alternatively, there is a Tier 4 Student Visa (https://www.gov.uk/tier-4-general-visa), which is necessary if you are studying in the UK for more than 6 months. This visa can be extended whilst in the UK and you can work for 20 hours per week. However, you will need to meet strict financial requirements and also provide an Immigration History Form before the University of Sunderland will assign you the CAS number needed to apply for a Tier 4 Visa. I intend to apply for: Short Term Study Visa Tier 4 (General) Student Visa If you select Tier 4, the University of Sunderland s Admissions team will email you further documents that will need completing and instructions to follow in order to receive your CAS number. 10. Declaration I confirm that, to the best of my knowledge, the information given in this application form is correct and complete. Applicant s signature Date Checklist Please include: A copy of the identity page of your passport A certificate or evidence of proficiency in English Language (if English is not your first language) Your most recent transcript of results from your home university An Educational Reference (found at the end of this application form) Fully completed Module Choices Please return your fully completed form and supporting documents to study.abroad@sunderland.ac.uk with the email subject Study Abroad/Exchange Application

Study Abroad and Exchange Programme Educational Reference The following student is applying to study at the University of Sunderland on the Study Abroad/Exchange Programme and requires an educational reference. Student s Full Name: Home University It would be helpful if you could include remarks on: Academic suitability of the applicant Level of motivation of the applicant Relevant personal qualities Your name: Position Name of Institution Date: Referee you can return this reference to the application or alternatively email the completed form as an attachment to study.abroad@sunderland.ac.uk with the email subject Educational Reference student s name.