supporting documents. - University of West London

INTERNATIONAL STUDENT
APPLICATION FORM
(NON-EU ONLY)
OFFICE USE ONLY
Applicant number Received Direct South Asia Office Agent
FURTHER INFORMATION
If you would like further information, please contact
int.app@uwl.ac.uk
All sections of this form must be completed.
Please write in CAPITAL letters, writing clearly in BLACK ink.
THANK YOU FOR APPLYING
This information will be treated confidentially in accordance with the University’s Data Protection Policy and the Data Protection Act, 1998.

PLEASE COMPLETE SECTIONS IN CAPITAL LETTERS
1. COURSE DETAILS
Course title
Level Foundation Undergraduate Post Graduate
Preferred start month September February
2. PERSONAL DETAILS
Title (Mr/Mrs/Ms/Miss/Dr) Gender Male Female
First name (as it appears on your passport)
Surname / family name (as it appears on your passport)
Previous Surname / family name (if changed)
Date of birth
D D M M Y Y Y Y
Permanent home address in home country
3. CONTACT DETAILS
E-mail
Landline (include country code)
Mobile (include country code)
UK address (if currently residing in the UK)
4. AGENT DETAILS
The below must be completed if the application is being made by an education agent
Name of education agency
Contact person
Address
E-mail
Telephone
Stamp

5. IMMIGRATION DETAILS
Nationality
Passport number
Passport issue date
Passport expiry date
Date of first entry to the UK
Date of most recent entry to the UK
Date you were granted exceptional leave to remain in the UK
Date you were granted full refugee status in the UK
Date you were granted indefinite leave to remain in the UK
Date on which your student visa was issued, and institution where you are currently studying
Date
Date on which your non-student visa was issued
Please specify type of visa
Date your visa expires
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
Institution
D D M M Y Y Y Y
Are you currently studying in the UK Yes No
If yes, please supply the name and address of the institution
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
D D M M Y Y Y Y
If yes, what level are you studying Foundation Undergraduate Post Graduate
6. ENGLISH LANGUAGE LEVEL
Name of test (IELTS, TOEFL, Pearson PTE etc.)
Overall score
Score in bands Reading Writing Listening Speaking
Date test was taken
7. CURRENT AND PREVIOUS EDUCATION (continue on additional sheets if required)
Name of institute Course title Awarding body
and country
Result/
grade
Start / end date
(MM / YY – MM / YY)

8. CURRENT AND PREVIOUS EMPLOYMENT
Name and address of
company
Job title and description Start date End date
9. PERSONAL STATEMENT
Please use this section of the form to provide information to support your application, including
your reason(s) for wishing to take the course of study and the benefits you expect to gain from it.
Please continue on a separate sheet if necessary.

10. REFERENCES
Referee 1 Name
Address
E-mail
Telephone (incl. country code)
Referee 2 Name
Address
E-mail
Telephone (incl. country code)
11. ETHNICITY
(11) British (12) Irish (19) Other white background
(31) Indian (32) Pakistani (33) Bangladeshi (34) Chinese (39) Other Asian background
(21) Caribbean (22) African (29) Other black background
(41) White & Black Caribbean (42) White & Black African (43) White & Asian
(49) Other mixed background (80) Other ethnic background (98) Information refused
12. DISABILITY
(01) Dyslexia (02) Blind/partially sighted (03) Deaf/hearing impaired
(04) Wheelchair user/ Mobility issues (05) Personal support needed
(6) Mental health difficulties (07) Unseen disability (08) Multiple disabilities
(09) Disability not listed above, please specify
None
13. CRIMINAL CONVICTIONS
Do you have any criminal convictions Yes
You must tick the YES box if you have a conviction, NOT including:
• a motoring offence that you received a fine or three penalty points for; or
• a spent sentence (as defined by the Rehabilitation of Offenders Act 1974), except for certain courses.
Please be aware that for certain courses, particularly in teaching, health, social work and other courses
involving work with children, you must tell us about ANY criminal conviction(s), including spent sentences
and cautions.
14. DECLARATION
To the best of my knowledge, the information I have given on this form is correct.
Signature Date D D M M Y Y Y Y
No

Please ensure you also send the following documents with this application:
• English Language qualification, where applicable
• Copies of qualification transcripts and certificates (including any studies in the UK)
• Copy of passport
Please send applications by post or by e-mail to the International Office.
International Office
University of West London
St Mary’s Road
Ealing
London W5 5RF
United Kingdom
int.app@uwl.ac.uk
uwl.ac.uk