TIER 4 (G)
TIER 4 (G)
TIER 4 (G)
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TIeR 4 (GeneRAl) APPlICATIOn FORM<br />
You must complete all of the sections and questions in this form that apply to you. The form will not<br />
be valid if it is not fully completed and your application will be rejected and returned to you.<br />
There is a separate help text leaflet available with this form. Where a question in this form has<br />
information available in the help text leaflet it will be marked with (ht)<br />
B. Your Personal Details<br />
In this section you will be asked to provide information about your personal situation, for example<br />
your name, date of birth and nationality as well as information about any other names you have<br />
used, or other nationalities you have held.<br />
Photographs<br />
For your application to be valid, you must provide two recent identical passport-size photographs<br />
of yourself with your full name written on the back of each one. The photographs must be in the<br />
format specified in the separate photograph guidance, including the mandatory requirements,<br />
which can be found on our website at http://www.ukba.homeoffice.gov.uk. Please ensure that<br />
you place the photographs in a small sealed envelope attached to this part of the form - and<br />
without allowing any staples, clips, pins or anything else to mark or damage the photographs. The<br />
photographs will be checked against the images taken when your biometric features are recorded.<br />
I have enclosed the required photographs as outlined in the box above.<br />
I am a low risk student and I am applying under the differentiation arrangements<br />
(please see paragraph 10 and 11 of the Tier 4 guidance for more information about<br />
this arrangement)<br />
B1. What is your name, as given in your passport or travel document? (ht)<br />
Title - please select from the following list:<br />
Mr Mrs Miss Ms Dr<br />
First name(s) or given name(s):<br />
Last name(s) or family name(s):<br />
B2. What is your gender? (ht):<br />
Male Female<br />
B3. What is your date of birth?<br />
D D M M Y Y Y Y<br />
B4. What is your relationship status? (ht):<br />
Married Dissolved Civil Partnership<br />
Civil Partner Surviving Civil Partner<br />
Single Unmarried Partner<br />
Divorced Separated<br />
Widow/Widower Separation Order<br />
Tier 4 (G) Application Form (version 10/12) - page 7
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