International Application Form

PERSONAL DETAILS

Title (Mr/Ms/Mrs/etc)
Surname/Family Name
Given Name Sex: Male Female
Date of Birth (day/month/year)
Correspondence Address
 
 
Country
Telephone Number (day) (evening)
Fax number (if any) Email (if any)

COURSE(S) APPLIED FOR

Desired Entry Date: Month Year
  Course Title Year/level of course
(eg.1,2,3)
Ist Choice    
2nd Choice    
3rd Choice    

ENGLISH LANGUAGE PROFICIENCY

English was the language of instruction in previous studies completed
I hold/will sit for the English language qualifcation(s) detailed below: 		YES/NO
YES/NO
Name of Test/Examination Date (to be) taken Result (if known)
Month Year
       
       

FEE STATUS

Country of birth Dates of any periods of residence in the European Union:
Nationality
Country of permanent residence

 Who is expected to pay your fees?

REFEREES

Please provide details of two people from whom an academic reference may be sought
Name Name
Address Address
   
   
Tel: Tel:
Fax: Fax:

WORK EXPERIENCE

Please list details of any work experience and attach a resume/summary providing more details, including a description of your duties and whether the work was full or part-time.
From
month/year		 To
month/year		 Name of Organisation Position / Job Title

 

 

      

 

 

      

 

 

      

PREVIOUS STUDY AND QUALIFICATIONS

Please list in chronological order all secondary and tertiary studies completed, and indicate whether full or part-time.
Please attach a copy of your certificates and transcripts of all results obtained to date, plus a certified translation if the originals are not in English.
From
(date)		 To
(date)		 Institution & location of Study FT/PT Qualification (to be) obtained
and subject /title		 date

 

 

          

 

 

          

 

 

          

 

 

          

 

 

          

STATEMENT IN SUPPORT OF APPLICATION

Please provide any further information you may wish to add in support of your application. We are particularly interested in your reasons for choosing the course(s), your career aspirations and your previous educational experience. Please attach a copy of your CV/resume if you have one.
 
 
 
 
 
 
 

DECLARATION

I confirm that, to the best of my knowledge, the information given in this form is correct and complete.

Applicant's signature

 

Date

Please return this form with a copy of your certificates and results to:
The International Office,
Leeds Metropolitan University,
Jean Monnet Building,
Beckett Park Campus,
Leeds,
LS6 3QS,
United Kingdom

Tel: +44 113 283 6111 Fax: +44 113 283 1776