University of Sussex Application form - Study Group

University of Sussex
Application form for International Study Centre
Summer Programme 2011
choose
Before filling in the application from, please
read the following instructions carefully:
• All applicants must complete all sections in block capitals
• Tick boxes where appropriate
Return it to the Student Enrolment Advisers at:
1 Billinton Way, Brighton BN1 4LF, United Kingdom.
T +44 1273 339333 F +44 1273 339398
www.sussex.ac.uk/isc

Application for ISC Summer Programme
Section A
www.sussex.ac.uk/isc
family name
other names
religion
country of birth
country of normal residence
title
student details
date of birth
age
sex male female
nationality
home address
city
country / post or zip code
marital status
first language
language of instruction to date
ethnicity
contact telephone
fax
email
tick this box if you would like to receive periodic special offers and news from usisc.
you can unsubscribe at any time, and your email address remains confidential.
parent/guardian
name
relationship to student
email
mobile
emergency telephone
home address
city
country / post or zip code
home telephone
fax
please give details of your current or most recent school, college or university. ensure official transcripts, latest available results or forecast results are attached, in english.
previous education
name of school/college/university
address
country / post or zip code
telephone
fax
email
Continue to section B

Section B
www.sussex.ac.uk/isc
insurance
accident & medical insurance
the full cost of studycare insurance will automatically be added to your invoice unless you can provide proof of alternative adequate cover.
i attach proof of my alternative policy
do you have any criminal convictions yes no if yes, please provide details on a separate sheet.
medical/disability/
special needs
please give details of such circumstances, including allergies and any reliance on
prescription medicines. continue on a separate sheet if necessary.
completion and signing of this form gives professional staff first aiders permission to
administer first aid to you if required. if you indicate that you have a medical condition,
disability or special need this information will be passed to the student support unit at
the university which may require further details. please note that consideration of how
we can meet any special needs is separate from the assessment of your academic ability.
arrival
students should arrive 24 to 48 hours prior to commencement of the course.
do you require airport collection? yes no if required, this will be invoiced as an extra charge
please include a copy of your passport page with your application
passport
passport number
expiry date
name as shown on passport
who is responsible for payment of your tuition fees?
who is responsible for payment of your accommodation fees?
payment details
once an offer of a place has been accepted we require a deposit of £500, together with £1000 advance payment of fees. you will also be required to pay in advance
the studycare insurance fee unless you have provided proof of alternative cover. payment can be made either by sterling bank draft, credit card, debit card or by direct bank
transfer. payment by visa, mastercard or amex is subject to a surcharge of 2%. payment by debit card has a £1 surcharge. our bank details are as follows:
bank address
NATIONAL WESTMINSTER BANK, HOVE TOWN HALL BRANCH, 103 CHURCH ROAD, HOVE BN3 2BS. ENGLAND.
account name INTERNATIONAL STUDY CENTRE swift code NWBK GB 2L account number 60060832
sort code 53-61-02 iban number GB92 NWBK 5361 0260 0608 32
please give details of the person/organisation responsible for payment of fees for financial information (invoices, statements, etc).
sponsor/payee
name
relationship to student
email
mobile
home address
city
country / post or zip code
contact telephone
fax
student/sponsor: i apply to enrol the person named as a student of usisc*. i undertake to pay all tuition and accommodation fees incurred as they become due in accordance
with the terms & conditions and either to give the required notice of cancellation or to pay the required fees in lieu of notice.
undertaking
signed student/sponsor
print name (student/sponsor)
signed parent/legal guardian (applicants aged under 18 years only)
date
print name (parent/legal guardian-applicants aged under 18 years only)
date
form of indemnity
by the parent, legal guardian or sponsor
this indemnity is to be signed by the student, and also by his/her parent or legal guardian if the student is under eighteen years of age. until this indemnity has been signed
and returned to the usisc*, the student may not take part in an expedition organised by usisc*.
in consideration of the principal/head teacher/director of usisc* agreeing to make arrangements for and to authorise members of the staff of usisc*
to take me/my son/daughter/ward from time to time on expeditions outside the premises of usisc*.
i hereby undertake to indemnify the principal/head teacher/director and such members of the staff against:
a) any claims, damages or costs which they or any of them may be, or become, liable to pay in consequence of any injury or damage to or illness of
me/my said son/daughter/ward occurring during or as a result of any of the said expeditions.
b) any claims by any third party which may be made against them or any of them in consequence of any act or default of me/my said son/daughter/ward
during or as a result of any of the said expeditions.
c) any other costs and expenses reasonably incurred by them or any of them on behalf of me/my said son/daughter/ward during or as a result of any of the said expeditions.
provided that the indemnity herein shall not extend to any claims, damages, costs or expenses in respect of and to the extent to which usisc*
and member(s) of the staff or any of them shall be entitled to be indemnified under any policy of insurance.
signed (student) date
signed (parent, legal guardian) date
* the usisc is administered and taught by a study group company, bellerbys educational services limited from brighton.
For applications Student Enrolment Advisers at: 1 Billinton Way, Brighton BN1 4LF, United Kingdom. T +44 1273 339333 F +44 1273 339398

Application for accommodation
www.sussex.ac.uk/isc
family name
title
other names
personal details
date of birth
age
sex male female nationality
correspondence address
country / post or zip code
mobile
telephone
email
emergency contact name
relationship to student
emergency
contact
address
country / post or zip code
mobile
telephone
email
residence
should you be offered and accept accommodation on campus you will be required to confirm that you undertake to abide by the terms and conditions of the university
accommodation, which will be sent to you at the time of enrolment and will form part of your residence contract. students should note that the university is not able to
guarantee your choice of room type or location.
which residential accommodation do you require?
self catered
catered
special
needs
if you have a special medical need which affects
your accommodation requirements we will make every
effort to allocate you to suitable accommodation.
please provide details of your needs.
other
information
please note here any other information which you would like us to take into account before allocating you a room.
declaration
in signing this application you should be aware that you are agreeing to abide by the
conditions of residence that can be viewed at:
www.sussex.ac.uk/residentialservices/1-4.html. the key points are detailed below:
• students living in university owned accommodation are licensees. your licence is
granted because of your intention to follow a course of study at the university.
if you cease to follow a course of study at the university you will be required to
leave residence.
• your licence is for a fixed period and there are financial penalties if you decide to
leave before the end of the period.
• you are required to conduct yourself in a responsible and safe manner and not to
disturb other residents
• the address in the uk at which notices (including notices in proceedings) may be
served on the landlord by the tenant or licensee is:
the housing office, bramber house, university of sussex, falmer, brighton, bn1 9qu
• all residences, including bedrooms, unless otherwise specified, are non-smoking.
• you must observe the university’s no-smoking policy.
• you may not sub-let your room or let anyone else live there.
i agree to abide by the conditions of residence yes no
signature
date
Accommodation is subject to availability. Alternative accommodation options may be offered for some intakes.
Other fees 2011/2012
self catered
catered
supplements
£700 per week
£900 per week
OFFICIAL USE ONLY
date received:
the full cost of studycare insurance, regardless of course length – will be
automatically added to your invoice unless you can provide proof of alternative
adequate cover. the insurance covers you until the end of your isc academic course.
airport transfer fee
£8 per week
gatwick £71
heathrow £109
This form should be returned to
the Student Enrolment Advisers.
F +44 1273 339333
Additional charges may be made for such items as accommodation security deposits, bedding packs, accommodation-specific insurance,
University administration fees and other sundry expenses. These items may be charged either to your ISC student account or your University
student account. Residential accommodation is subject to availability and early confirmation is advised.

Terms and Conditions
Important
Please ensure you read these Terms and
Conditions carefully and understand them
before signing your final acceptance of a
place at University of Sussex International
Study Centre (hereafter referred to as
USISC). These Terms and Conditions referred
to herein constitute the entire agreement
between the parties and shall supersede
any and all promises, representations,
warranties or other statements whether
written or oral made by or on behalf of one
party to the other of any nature whatsoever
or contained in any leaflet brochure or other
document given by one party to the other
concerning such subject matter. The USISC
is administered and taught by a Study
Group company, Bellerbys
Educational Services Limited from Brighton
(Bellerbys). By signing these Terms and
Conditions you give permission for your
son/daughter to participate in outings
arranged by the USISC.
1. Enrolment
All enrolments are subject to the following
conditions which become legally binding on
acceptance of enrolment by Bellerbys. All
fees including application fee must be paid
in full 14 days before your course starts.
2. Services
The company reserves the right to change
the particulars of the services, including
changes to courses, locations, facilities and
dates of the programmes where
circumstances beyond the company’s
control necessitate such changes or where
the number of bookings received does not
reach the minimum numbers required to
operate a course viably.
3. Refund policy
The following are charges and refunds if
you cancel or withdraw from a course.
• • All payments are refundable in the event
that a student is unable to meet visa entry
requirements, except in the case where
fraudulent documents have been
submitted, subject to receipt of an official
visa rejection letter or Study Group have
withdrawn sponsorship.
• If we reject your application or your visa
application is rejected after we have
• Confirmed your place, there will be no
charge and you will receive a full refund
within 30 days.
• If you cancel your course in writing up to
48 hours before the start date, you will be
charged 30% of the package price.
• If you cancel your course less than 48
hours before the start date or fail to arrive,
or if you cancel in writing after the start
date on the grounds of force majeure,
100% of the full package price will be
charged.
• If you withdraw from the course after the
start date, 100% of the full package price
will be charged.
• Any application fees and airport transfer
fees are non-refundable.
4. Visas
Some students require a student visa or
tourist visa. Students should contact their
nearest Consulate or High Commission for
conditions of all visa categories. Arranging
the correct visa is the sole responsibility of
the student or agent.
5. Liability
Bellerbys and its staff and representatives
will not be liable for any loss, damage or
injury to persons or property howsoever
caused, except where liability is expressly
imposed by law. The USISC will not be liable
in the event that any service contracted to
be supplied by Bellerbys becomes
impossible to supply for any reason or any
cause outside the control of Bellerbys. The
student or agent making the booking shall
be liable for any costs incurred by Bellerbys
as a result of changes to the details of the
booking not communicated in writing to
Bellerbys at least one week before arrival.
This liability includes, but is not limited to,
accommodation charges and transport
costs.
Please note this particularly applies to
transfer costs incurred through cancelled
flights and missed flight connections,
whereby Bellerbys is charged for transfers
already booked. Note: All prices contained in
this brochure are valid until 31st August 2011
6. Medical insurance
It is a condition of making a booking with
Bellerbys that all students have appropriate
medical and health insurance. Students
must either take out our own StudyCare
insurance policy or provide proof of
adequate cover at enrolment. The StudyCare
insurance fee is non-refundable.
7. Behaviour and Discipline
As all our students choose our courses to
obtain the best programme possible we
owe it to all our guests to make sure that
they can study and enjoy their stay
to the fullest. The USISC reserves the right
to terminate the programme of any person
or group whose behaviour is likely in our
opinion to cause distress, damage or danger
to other participants, USISC employees or
anyone else. Bellerbys reserves the right to
terminate the programme of any person or
group whose behaviour is contrary to
applicable local laws. This behaviour
includes but is not limited to: under-age
purchase or consumption of alcohol,
possession of illegal substances, damage to
property, threatening or violent behaviour.
8. Liability
Students or group leaders who disregard
the rules laid down by our staff may be sent
home. Bellerbys will not be liable for any
costs incurred in repatriating a person or
group to their country of origin. No refund
will be made for any programme missed as
a result of such termination. No discussion
will be entered into once this has occurred.
We reserve the right to exclude any person
from our programmes without explanation.
9. Our Student Discipline Procedure
Our general discipline procedure in cases
of misbehaviour is as follows: In the first
instance a student will be given a verbal
warning. If the incident is repeated then a
student can immediately be issued with a
written warning, the second stage of our
discipline procedure. Once a written
warning has been issued, the USISC will
contact the agent as soon as possible,
allowing differences in time zones. Any
student who has been issued with a written
warning will be made fully aware that any
further incidents, will result in removal from
the centre.
10. Resolution of disputes
If a student, group leader or agent wishes to
complain about any aspect of the services
provided by Bellerbys, such complaint must
initially be made to the company or Head of
Centre or representative on site. Unless
there is a valid reason why this is not
possible, we will not consider ourselves
liable for any complaint not made at the
time. In the event that the matter is not
resolved, the student or group leader or
agent should make a complaint in writing
to the Principal, International Study Centres,
in the head office in Brighton. Such
complaints will be investigated in full
providing that:
• The complaint is received within one
month of the termination of the course.
• The complaint was initially registered in
writing with an on-site representative or
Centre Manager.
• All invoices relating to the student making
the complaint have been settled in full.
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