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University of Surrey International Study Centre 2012 ... - Study Group

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Declaration<br />

How did you hear about us?<br />

Choose one <strong>of</strong> the following:<br />

Agent Educational Fair Friend/relative recommendation Other (please specify)<br />

Undertaking – by the student (if over 18), parent, legal guardian or sponsor.<br />

If the student is under 18, this must be signed by the parent or legal guardian.<br />

I apply to enrol the person named as a student <strong>of</strong> <strong>University</strong> <strong>of</strong> <strong>Surrey</strong> <strong>International</strong> <strong>Study</strong> <strong>Centre</strong> (SISC). I undertake to pay all tuition and accommodation fees<br />

incurred by the student as they become due in accordance with the SISC Terms and Conditions and, where relevant, either to give the required notice <strong>of</strong> cancellation<br />

or to pay the required fees in lieu <strong>of</strong> notice. I give permission for the administration <strong>of</strong> first aid and appropriate non-prescription medication to myself/the student,<br />

and to seek medical, dental or optical treatment when required. I also confirm that I have advised you <strong>of</strong> any medicines currently being taken, or any ongoing<br />

medical condition.<br />

I confirm that I have read the Terms and Conditions.<br />

Full Name (student/sponsor)<br />

Signed<br />

Date<br />

Parent/Legal guardian (if student is under 18)<br />

Signed<br />

Date<br />

Before sending the application form, please check that you have:<br />

completed the form in full including the degree aim and student’s email and telephone number and checked for accuracy<br />

enclosed pro<strong>of</strong> <strong>of</strong> alternative insurance policy, if relevant<br />

enclosed full transcript <strong>of</strong> all your relevant qualifications, translated into English<br />

enclosed a Certificate for a Secure English Language Test such as IELTS, TOEFL ibt or Pearson Test <strong>of</strong> English or Pre-Arrival English Test<br />

enclosed a copy <strong>of</strong> your passport<br />

enclosed a signed student declaration form (applicable to students from China and Bangladesh only)<br />

12653 12/11<br />

*The <strong>University</strong> <strong>of</strong> <strong>Surrey</strong> <strong>International</strong> <strong>Study</strong> <strong>Centre</strong> is administered and taught by a<br />

<strong>Study</strong> <strong>Group</strong> Company, Bellerbys Educational Services Limited from Brighton<br />

Send applications to: <strong>International</strong> Admissions <strong>Centre</strong>, 1 Billinton Way, Brighton, BN1 4LF, United Kingdom<br />

Telephone + 44 1273 339300 Fax + 44 1273 339301<br />

5

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