Immigration Information Form

Applicant Details Before completing this form, please read the document Tier 4 Sponsorship and the issuing of
Confirmation of Acceptance for Studies (CAS) which outlines LSBUs position on the issuing of CAS
LSBU ID 3513916 to students: https://my.lsbu.ac.uk/my/applicant/Current-Applicants/Regulations
Name Please answer all questions and sections which are relevant to you. Please state N/A if the
Joka Talent
question is not applicable to you.
Date of Birth 18/01/1993 It is essential that you complete this form. The information is required in order to
proceed with your admission to and enrolment at the University. Your offer may be withdrawn if you
Programme MSc Advanced already hold an offer and fail to submit this form.
Telecommunications and Wireless Please attach all relevant documentation regarding your immigration history (e.g.
copies of all UK visas, enrolment/CAS letters, completed UK qualifications, permission to switch,
Engineering refusal letter, appeal letters, academic progress, Home Office correspondence etc. as appropriate)

Have you previously applied for a visa to Where are you planning to submit your visa Have you ever had a visa refused?
enter or remain in the UK? application from?

Yes Inside the UK Yes If yes, please see box below

No Outside the UK Country:______________ No

Have you ever taken an Educational If you are eligible, will dependents be Do you currently have a visa application
Testing Service (ETS) TOEIC test? joining you to the UK while you study (e.g. pending with the Home Office?
(see website for more information: spouse, partner, children)?
https://www.ets.org/toeic)

Yes Yes Number _____ Yes

No No No

If you have had a visa refused please send us a copy of the refusal letter and give details in the box below:
Notes
 Immigration Information Form
Important:
If you have previously applied for a visa to enter or remain in the UK, please include details of all UK visas that you have been granted, and
complete the form clearly and accurately. For non-Tier 4 visas (e.g. Visit, Tier 2) you only need to complete the first three columns highlighted in
bold.
Give as much information as you can in the table below. There is space below to give more details should it be necessary.

Visa type (1) Visa start Visa end Name of Course Visa Institution name Level of study Course Course Qualifications completed
date date was issued for (2) start date end date whilst on this visa e.g. PGDip,
(actual) (3) BSc, MSc

(1) e.g. Tier 4 Student, Student Visitor,

Student visa, Tier 1 Post Study Work (2) e.g. Please include the NQF level, or if you studied English Language Course the (3) Please state the actual course start date. This maybe
visa CEFR level e.g. B1 or B2. The level of Study will be stated on previous CAS Statements. different to what is stated on the course CAS statement.

If any of the following apply to you, please give a detailed explanation in the Notes box below:

1. There are gaps in your immigration history;

2. You have failed to complete a course that you were sponsored for;
 Immigration Information Form
3. You completed a course for which you were not originally sponsored for;
4. Any further relevant information you would like to state

Notes

By signing below you assert the following:

- I have read and understood the document Tier 4 Sponsorship and the issuing of Confirmation of Acceptance for Studies (CAS) (available here:
https://my.lsbu.ac.uk/my/applicant/Current-Applicants/Regulations)
- I have attached all relevant documentation regarding my immigration history. (Including, but not limited to: copies of all UK visas, enrolment/CAS letters,
completed UK qualifications, permission to switch, appeal letters, academic progress, Home Office correspondence etc. as appropriate.)
- I confirm that the information given in this form is correct and complete. I understand that the University reserves the right to withdraw any offer or cancel a
registration made on the basis of the information which proves to be false or misleading.

Signature: (must be hand written*) Date: (must be hand written*)

_______________________________________ __________________________________________

*Electronic signatures are not accepted