International Application Form

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1 Agency Stamp (if applicable) or University stamp if Erasmus or inter-institutional agreement student International Application Form For instructions on completing this form please refer to the guidance notes, available separately SECTION ONE: Course Information Course Type: International Foundation Other Foundation Undergraduate Erasmus Exchange Study Abroad Exchange Postgraduate Certificate Postgraduate Diploma Masters Undergraduate applicants from the EU/EEA/Switzerland should apply online via UCAS: Applicants for the PGCE should apply online via the GTTR at: Applicants for the MA Social Work should apply online via UCAS: Applicants for MPhil and PhD study should apply on a separate application form, available at: Name: Course Name: Course code: (Undergraduate only) Mode of Study: Full Time Part Time Month of Entry: September/October Year of Entry: Level of Entry: Year 0 (Foundation only) Year 1 Year 2 Year 3 (Undergraduate and Exchanges) (Undergraduate only)

2 SECTION TWO: Personal Details Title: Mr Mrs Ms Miss Dr Other: Gender: Male Female Family Name: First Names: Date of Birth: Day: Month: Year: Age at start of proposed course: SECTION THREE: Contact Details It is important to include your address, as we will use this as our main method to contact you. address: Mobile telephone number: Correspondence Address: Telephone number: Permanent Address (if different): Telephone number:

3 SECTION FOUR: Immigration Status Are you a UK national? Yes No If you are not a UK national, are you a European Union (EU)/ European Economic Area (EEA)/Swiss national? If Yes, please state your nationality: Yes No If you are a UK/EU/EEA/Swiss national, have you been living outside the UK/EU/EEA/ Switzerland for the past 3 years? If Yes, please give details (including dates outside the EU/EEA/Switzerland): Yes No If you are living in the EU and were not born in the EU please state: Date of first entry to the EU: Date of most recent entry to the EU: Date from which you have been granted permanent residence in the EU: If you are not a UK/EU/EEA or Swiss national please state: Country of birth: Nationality: Country of residence: Please ensure you send in a copy of your passport details page and any visa you may hold with your application.

4 SECTION FIVE: Use of Agency Are you applying via an Educational Agency or Representative? Yes No If you are applying via an Educational Agency / Representative, please provide the name of the Agency / Representative below and sign the following statement: I have been advised and counselled by the above agency, have been informed of their terms and conditions and authorise them to represent me in my application Signature: Date: SECTION SIX: International Students Disability Support International Students Disability Support Canterbury Christ Church University welcomes applications from prospective disabled students and is committed to ensuring that all students have right of access to all the University s buildings and services. It is important to note that International and non-uk EU students are not entitled to the UK Government allowances for disabled students and, whilst the University will make every effort to support you, it will be the responsibility of you and your sponsors to fund any additional support costs which arise as a consequence of your disability. Additional Funding Disabled students from outside the UK may find that they are eligible to apply for financial support to a charity or other funding body. The decisions on eligibility and amount of funding are made by them, not by the University. The Snowdon Trust applications considered from students who have physical impairment. Erasmus Students studying at Canterbury Christ Church University

5 Services at Canterbury Christ Church University for disabled students The University s Student Disability Advice Team will be able to provide some support at no or little additional cost to you or your sponsor. This includes: access to assistive technology resources ability to record lectures and seminars possible short term loan of equipment where available reformatted examination papers extended Library loans adapted accommodation if available support from the Disability Advice Service Braille Transcription modified examination arrangements where appropriate There are additional services that you may require which will have a cost associated with them, and it is possible that the full or partial costs will be charged to you or your sponsor: sign language interpreters note-takers, readers, personal support workers individual learner support and dyslexia support equipment such as computers, digital audio recorders assistive software e.g. Jaws (except for that available on terminal services) familiarisation/mobility training It is imperative that you contact the Disability Advice Team before you accept the offer of a place, to discuss the cost of these services. If you do not have a sponsor, or another source of financial support to pay for any disability support, you should talk to the Disability Advice Team about this. However, please note that alternative sources of funding are likely to be limited (please see advice on funding above). Support with day to day living The University will provide some support for your academic needs, but cannot provide support for personal care and daily living tasks (for example, help with walking or mobility, shopping, cooking, and cleaning) this kind of support will need to be funded by you or your sponsor. Please note also that the University has only a limited range of adapted accommodation, and major adaptations to existing accommodation cannot be funded by the University, should you require them. You will need to think carefully about any non-academic, disability related support you may require whilst living and studying in the UK. The University may be able to advise you on agencies that can support you with your daily living (e.g. cooking, cleaning, shopping), but you will have to meet the cost of this support yourself. Please contact the Disability Advice Team to discuss before your application, as this kind of support must be planned and resourced well in advance. For more information please

6 Please indicate if you have any special needs or require any support due to any disability or medical condition: Specific learning disability (e.g. dyslexia) Blind or partially sighted Deaf or hearing impaired Wheelchair or mobility difficulties Autistic Spectrum Disorder or Asperger Syndrome Mental health difficulties Unseen disability (e.g. diabetes, epilepsy, heart condition) Other (please explain below) If you have ticked any of these boxes please provide us with more information on the next page so that we are fully aware of your support needs:

7 SECTION SEVEN: Qualifications Please state any qualifications held or currently being studied; these must include your highest level of qualifications. Please quote the original names of qualifications do not translate to the UK equivalent. High School Qualifications School or College Name: Dates Attended: To: Qualification Title: Overall GPA (if relevant): For example: 3.0/4.0 Subjects: Grades: Pre-University Qualifications (if applicable) School or College Name: Dates Attended: To Qualification Title: Overall GPA (if relevant): For example: 3.0/4.0 Subjects: Grades:

8 University Qualifications (If applicable) Undergraduate University Name: Dates Attended: To Qualification Title: Overall GPA (if relevant): For example: 3.0/4.0 Subject: Grade: Postgraduate University Name: Dates Attended: To Qualification Title: Overall GPA (if relevant): For example: 3.0/4.0 Subject: Grade: Professional or Any Other Qualifications (If applicable) Institution Name: Dates Attended: To Qualification Title: Overall Grade (if relevant): Please provide photocopies of any certificates and transcripts with this application.

9 SECTION EIGHT: English Language Qualifications Have you ever taken a formal English Language Examination or Test? Yes No If yes, please enter details of the test(s) have you taken If no, but you have booked a test, please enter the test date below UK Qualifications GCSE/IGCSE English Language O level English Language Date Taken Overall Grade Reading Score Writing Score Speaking Score Listening Score IELTS Qualifications Academic IELTS General IELTS TOEFL Qualifications ibt PBT Pearson Test of English PTE Academic University of Cambridge ESOL First Certificate in English (FCE) Certificate in Advanced English (CAE) Certificate of Proficiency in English (CPE) Other Tests (please provide details) If your test provider offers an online results verification service and you wish to share your result online with Canterbury Christ Church University, please provide the requested information below: Cambridge ESOL Results Verification Service IELTS TRF Verification Service TOEFL Online Score Verification Service Pearson Test of English Academic Information Required to Verify Test Results Online Identification Secret Number: Number: TRF Number: TOEFL Registration Number: To share your PTE Academic score with us, log in to your Pearson account, select your PTE Academic score and click Send Scores If you are not providing online verification of your results, please provide photocopies of any English Language certificates with this application

10 SECTION NINE: Employment Please give details of any positions of employment you have held, listing the current or most recent first: Dates: To: Employer: Role: Responsibilities: Dates: To: Employer: Role: Responsibilities: Dates: To: Employer: Role: Responsibilities:

11 SECTION TEN: Personal Statement Please state below your reasons for applying for this course and mention any relevant previous study or experience. If you do not have an International English test result please explain your level of English and where and for how long you have studied English. Your personal statement must be words in length.

12 SECTION ELEVEN: How did you hear about us? Where did you first learn about Canterbury Christ Church University? Friends Family Teacher British Council Education Fair UCAS Education Agency Internet Newspaper Other (please state) SECTION TWELVE: Declarations Do you have any relevant criminal convictions? Yes No If Yes please provide details: By signing the declaration below, you declare that: You are aware of the tuition fees for your desired course, available at: You are aware of the recommended allowances for the cost of living, available at: You have read the CCCU pre-arrival guide available at: By signing this form you declare that all information given on this form is true and accurate and has been completed solely by you. Signature: Date: Your signature must be handwritten

13 Applicant Checklist Included To Follow Completed application form Reference(s) English Language test certificate Photocopies of academic certificates / transcripts Portfolio /Audition CD/DVD/Online link (if required) Additional information sheet (if required) Photocopy of passport details or EEA identity card Photocopy of existing visa (if appropriate) Photocopy of signed learning agreement (Erasmus only) Please refer to the guidance notes, available separately, if you are unsure about whether you require any of the above Submitting your Application Please return your completed application form to: Admissions Department Canterbury Christ Church University North Holmes Road Canterbury Kent CT1 1QU England Telephone: Fax: Please forward a copy of this application form to your referee once you have completed it. Your referee should then return the application form to you, alongside your reference which should be in a sealed envelope. Please note that your referee may prefer to send the reference directly to Canterbury Christ Church University, so please agree the procedure with your chosen referee at the time of request.

14 URGENT REFERENCE REQUEST To the referee: Please give your opinion of the candidate s suitability for the course chosen to cover the applicant s academic ability, and personal qualities. Applicant Name: Course Applied for: Comments: Name: Organisation: Position: Telephone Number: address: Signature: Date: Please return your completed reference to the applicant in a sealed envelope. Alternatively, you can return the reference directly to: Canterbury Christ Church University, Admissions Department, North Holmes Road, Canterbury, Kent. CT1 IQU

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