TIER 4 (G)

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TIeR 4 (GeneRAl) APPlICATIOn FORM Section Q - Representative’s Declaration If you are a representative acting in relation to this application you must complete the declaration below to show you have read and understood the representative’s declaration and to confirm that you are authorised to act on behalf of the applicant(s). I have been appointed by the applicant(s) to act on their behalf in relation to this application which has been submitted online to the UK Border Agency. I confirm that I am aware of the contents of this application, including its supporting documents, and that the application is, to the best of my knowledge and belief, true and correct. I confirm that I will promptly give the applicant all correspondence I receive from the UK Border Agency about this application. I am permitted to give immigration advice and immigration services by virtue of section 84 of the Immigration and Asylum Act 1999. I am aware that it is an offence to do an act which facilitates a person who is not a citizen of the European Union to commit a breach of immigration law, knowing or having reasonable cause to believe that the act has this effect. Name Signature Date Name of your organisation: Your position within the organisation: Tier 4 (G) Application Form (version 10/12) - page 36 D D M M Y Y Y Y
SUMMARY SHeeT TIeR 4 (GeneRAl) APPlICATIOn FORM Fill in this part of the form to help us to make sure that we have received the student’s documents and to keep a record of them while they are with us. At “A”, tell us how many of each of the listed documents the student has sent with this application. This is a standard list, students should only send in the documents from this list that are required for their application. At “B”, list any other documents and state how many in each case. Continue on a separate sheet if necessary. Part A - Type of document How many? Part B - listed Items How many? Passports Biometric Residence Permits and/ or travel documents Police registration certificates Marriage or civil partnership certificates Birth certificates Driving Licences 2 photographs Letter of consent from parent/ guardian Fill in the summary sheet below listing the supporting evidence (documents) sent. You must send the required evidence as specified in this application form and the Tier 4 of the points based system Policy Guidance. Failure to submit required evidence is likely to lead to refusal of your application. Area Documents provided (please list) Possession of a Confirmation of Acceptance for Studies (CAS) Maintenance (Funds) Finally please ensure that your application is addressed correctly, as given on the front of this form. Tier 4 (G) Application Form (version 10/12) - page 37
Page 1 and 2: APPLICATION FOR A GRANT OF LEAVE AN
Page 3 and 4: A. Payment Details TIeR 4 (GeneRAl)
Page 5 and 6: Dependant 1 - First name Last name
Page 7 and 8: TIeR 4 (GeneRAl) APPlICATIOn FORM Y
Page 9 and 10: TIeR 4 (GeneRAl) APPlICATIOn FORM S
Page 11 and 12: TIeR 4 (GeneRAl) APPlICATIOn FORM D
Page 17 and 18: H7; What date did you move to this
Page 19 and 20: I9; Date of the judgement or civil
Page 23 and 24: TIeR 4 (GeneRAl) APPlICATIOn FORM J
Page 25 and 26: K10. Have you claimed Housing Benef
Page 27 and 28: L9. What date does your course end?
Page 29 and 30: TIeR 4 (GeneRAl) APPlICATIOn FORM M
Page 35: Section P - Your Declaration TIeR 4

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