APPLICATION FORM TIER 4 VISA UK

APPLICANT NAME:
PURPOSE OF APPLICATION:
PASSPORT / TRAVEL DOCUMENT
FAMILY NAME / SURNAME
GIVEN NAME(S) / FORENAME(S)
HAVE YOU EVER USED, OR BEEN KNOWN BY, ANY OTHER
NAMES? THIS INCLUDES A MARRIED NAME, MAIDEN NAME,
NAME AT BIRTH, PROFESSIONAL NAME
HAVE YOU EVER USED, OR BEEN KNOWN BY, ANY OTHER
NAMES? THIS INCLUDES A MARRIED NAME, MAIDEN NAME,
NAME AT BIRTH, PROFESSIONAL NAME
PLACE OF BIRTH
GENDER
PLACE OF BIRTH
NATIONALITY
DO YOU CURRENTLY HOLD, OR HAVE YOU EVER HELD, ANY
OTHER NATIONALITY OR NATIONALITIES?
CURRENT PASSPORT OR TRAVEL DOCUMENT NUMBER
PLACE OF ISSUE
ISSUING AUTHORITY
DATE OF ISSUE
DATE OF EXPIRY
COUNTRY OF RESIDENCE
ARE YOU A NATIONAL OF THE COUNTRY IN WHICH YOU ARE
APPLYING?
IS THIS YOUR FIRST PASSPORT?
DOCUMENT NUMBER
ISSUING AUTHORITY
DATE OF ISSUE
DATE OF EXPIRY
IS THIS DOCUMENT LOST, STOLEN OR IN YOUR POSSESSION
TRAVEL INFORMATION
ARE YOU TRAVELLING WITH ANYONE?
DATE OF PLANNED ARRIVAL IN THE UK
HOW LONG DO YOU INTEND TO STAY IN THE UK?
WHAT IS THE MAIN ADDRESS AND CONTACT DETAILS OF
WHERE YOU WILL BE STAYING WHILST IN THE UK?
PERSONAL DETAILS
WHAT IS YOUR PERMANENT RESIDENTIAL ADDRESS AND
CONTACT DETAILS?
HOW LONG HAVE YOU LIVED AT THIS ADDRESS?
ARE YOUR PREFERRED CONTACT DETAILS DIFFERENT FROM
THE CONTACT DETAILS ALREADY PROVIDED ABOVE?
TRAVEL AND CRIMINAL HISTORY
HAVE YOU BEEN ISSUED ANY VISA FOR THE UK, UK
OVERSEAS TERRITORIES OR COMMONWEALTH COUNTRY IN

THE LAST 10 YEARS?

TYPE OF VISA ISSUED
DATE OF ISSUE
DATE OF EXPIRY
ISSUING AUTHORITY
HAVE YOU EVER TRAVELLED TO THE UK IN THE LAST 10 YES
YEARS?
DATE OF ARRIVAL
DEPARTURE DATE
PURPOSE OF THE TRIP
DATE OF ARRIVAL
DEPARTURE DATE
PURPOSE OF THE TRIP
Include all
HAVE YOU MADE AN APPLICATION TO THE HOME OFFICE TO
REMAIN IN THE UK IN THE LAST 10 YEARS?
HAVE YOU BEEN REFUSED ENTRY TO THE UK IN THE LAST 10
YEARS
HAVE YOU BEEN REFUSED A VISA FOR ANY COUNTRY
INCLUDING THE UK IN THE LAST 10 YEARS?
HAVE YOU BEEN DEPORTED, REMOVED OR OTHERWISE
REQUIRED TO LEAVE ANY COUNTRY INCLUDING THE UK IN
THE LAST 10 YEARS?
HAVE YOU EVER VOLUNTARILY ELECTED TO DEPART THE UK?
ARE YOU, OR HAVE YOU BEEN SUBJECT TO, AN EXCLUSION
ORDER FROM THE UK?
HAVE YOU EVER TRAVELLED OUTSIDE YOUR COUNTRY OF
RESIDENCE, EXCLUDING THE UK, IN THE LAST 10 YEARS?
DATE OF ARRIVAL
DEPARTURE DATE
PURPOSE OF THE TRIP
DATE OF ARRIVAL
DEPARTURE DATE
PURPOSE OF THE TRIP
DATE OF ARRIVAL
DEPARTURE DATE
PURPOSE OF THE TRIP
Include all
DO YOU HAVE A UK NATIONAL INSURANCE NUMBER?
HAVE YOU EVER BEEN CONVICTED OF ANY CRIMINAL
OFFENCE IN THE UK OR ANY COUNTRY?
HAVE YOU BEEN ARRESTED AND CHARGED WITH ANY
OFFENCE IN ANY COUNTRY AND ARE AWAITING, OR ARE
CURRENTLY ON TRIAL?
HAVE YOU EVER BEEN INVOLVED IN, SUPPORTED OR
ENCOURAGED TERRORIST ACTIVITIES IN ANY COUNTRY?
HAVE YOU EVER BEEN A MEMBER OF, OR GIVEN SUPPORT TO,
AN ORGANISATION THAT HAS BEEN CONNECTED WITH
TERRORISM?
HAVE YOU EVER, BY ANY MEANS OR MEDIUM, EXPRESSED
VIEWS THAT JUSTIFY OR GLORIFY TERRORIST VIOLENCE, OR

THAT MAY ENCOURAGE OTHERS TO COMMIT ACTS OF

TERRORISM OR OTHER SERIOUS CRIMINAL ACTS?
IN TIMES OF EITHER PEACE OR WAR HAVE YOU EVER BEEN
INVOLVED IN, OR SUSPECTED OF INVOLVEMENT IN, WAR
CRIMES, CRIMES AGAINST HUMANITY OR GENOCIDE?
HAVE YOU ENGAGED IN ANY OTHER ACTIVITIES THAT MIGHT
INDICATE THAT YOU MAY NOT BE ADMITTED TO THE UK?
IF WE NEED TO INTERVIEW YOU, WHAT LANGUAGE WOULD
YOU LIKE TO USE IN THE INTERVIEW?
HAVE YOU RECEIVED ANY OTHER PENALTY IN RELATION TO A
CRIMINAL OFFENCE; FOR EXAMPLE A CAUTION, REPRIMAND,
WARNING, OR SIMILAR PENALTIES IN THE UK OR ANY OTHER
COUNTRY?
HAVE YOU HAD ANY UK COURT JUDGEMENT AGAINST YOU
FOR NON-PAYMENT OF A DEBT, OR RECEIVED A CIVIL
PENALTY UNDER UK IMMIGRATION ACTS?
FAMILY DETAILS SPOUSE / PARTNER
WHAT IS YOUR MARITAL STATUS?
IF YOU ARE MARRIED
NATIONALITY
FAMILY NAME / SURNAME
(IF THEY ONLY HAVE ONE NAME, PLEASE ENTER IT HERE AND
IN THE GIVEN NAME BOX)
GIVEN NAME(S) / FORENAME(S)
(IF THEY ONLY HAVE ONE NAME, PLEASE ENTER IT HERE AND
IN THE FAMILY NAME BOX)
DATE OF BIRTH PLACE OF
BIRTH

FATHER
NATIONALITY
FAMILY NAME / SURNAME
(IF THEY ONLY HAVE ONE NAME, PLEASE ENTER IT HERE AND
IN THE GIVEN NAME BOX)
GIVEN NAME(S) / FORENAME(S)
(IF THEY ONLY HAVE ONE NAME, PLEASE ENTER IT HERE AND
IN THE FAMILY NAME BOX)

DATE OF BIRTH PLACE OF

BIRTH

MOTHER
NATIONALITY
FAMILY NAME / SURNAME
(IF THEY ONLY HAVE ONE NAME, PLEASE ENTER IT HERE AND
IN THE GIVEN NAME BOX)
GIVEN NAME(S) / FORENAME(S)
(IF THEY ONLY HAVE ONE NAME, PLEASE ENTER IT HERE AND
IN THE FAMILY NAME BOX)
DATE OF BIRTH PLACE OF
BIRTH

DEPENDENT CHILDREN
DO YOU HAVE ANY DEPENDENT CHILDREN
NON DEPENDENT CHILDREN
ARE ANY OTHER CHILDREN TRAVELLING WITH YOU?
MEDICAL TREATMENT
HAVE YOU EVER RECEIVED MEDICAL TREATMENT IN THE UK?
TIER 4 STUDENT SPONSOR
GIVE YOUR TIER 4 SPONSOR'S LICENCE NUMBER
WHAT IS THE NAME OF YOUR SPONSOR?
WHAT IS THE FULL ADDRESS OF YOUR SPONSOR?
STUDIES
WHAT IS YOUR CONFIRMATION OF ACCEPTANCE FOR STUDIES
NUMBER?
WHAT IS THE TITLE OF YOUR COURSE?
WHAT IS THE LEVEL OF THE COURSE AND QUALIFICATION?
START DATE OF COURSE END DATE OF COURSE
HAVE YOU ALREADY STARTED STUDYING THIS COURSE?
WHAT IS THE ADDRESS OF THE MAIN SITE OF STUDY?
CONFIRM WHICH OF THE FOLLOWING OPTIONS APPLY
HAVE YOU BEEN ASSESSED BY THE SPONSOR BY OTHER
MEANS, FOR EXAMPLE REFERENCES OR A PORTFOLIO OF

ARTWORK?
PLEASE INDICATE HOW YOU MEET THE MINIMUM ENGLISH
LANGUAGE REQUIREMENT RELEVANT TO YOUR COURSE
ARE YOU REQUIRED TO OBTAIN PERMISSION FROM THE
ACADEMIC TECHNOLOGY APPROVAL SCHEME (ATAS)?
MAINTENANCE AND FEES

HOW MUCH ARE THE FEES FOR YOUR COURSE OF

STUDY?

HAVE ANY OF YOUR COURSE FEES BEEN PAID?

DO YOU HAVE SUFFICIENT FUNDS TO COVER
REMAINING COURSE FEES?

HAVE ANY OF YOUR ACCOMMODATION FEES BEEN PAID

TO YOUR SPONSOR?

DO YOU RECEIVE SUPPORT FROM A FINANCIAL SPONSOR

THAT MEETS THE UK VISA AND IMMIGRATION DEFINITION OF
A FINANCIAL SPONSOR?

DO YOU HAVE ANY REMAINING FEES AND

MAINTENANCE STILL DUE FOR PAYMENT?

COURSE FEES
MAINTENANCE
TOTAL
DO YOU HAVE MONEY IN YOUR OWN NAME?
WHAT EVIDENCE HAVE YOU PROVIDED THAT SHOWS BOTH
THE AMOUNT OF FUNDS AVAILABLE AND YOUR
RELATIONSHIP TO YOUR PARENTS OR LEGAL GUARDIANS?
POINTS CLAIMED
CONFIRMATION OF ACCEPTANCE FOR STUDIES
MAINTENANCE

TOTAL
ADDITIONAL INFORMATION
IS THERE ANY OTHER INFORMATION YOU WISH
TO BE CONSIDERED AS PART OF YOUR
APPLICATION?