Application Form - WORD format

Document Sample
Application Form - WORD format Powered By Docstoc
Application Form                                                                                    Here
For Admission                              Application No:

Please read the information contained in the Guidance Notes before completing this form

 Section 1: Applicant Details

 Surname: __________________________________                 First Name: ____________________________________

 Mr/Mrs/Miss/Ms/Other (please specify) _________             Nationality: ____________________________________

 Address in UK (if any): _______________________             Overseas Address: _____________________________

 __________________________________________                  _____________________________________________

 __________________________________________                  _____________________________________________

 Date of Visa Expiry (if applicable) ______________          Date of Entry in UK (if applicable) __________________

 Passport No: ________________________________               Passport Expiry: ________________________________

 Overseas Contact No: ________________________               UK Contact No: _________________________________

 Overseas Mobile No: _________________________               Sex Male:                Female:

 Email address: ______________________________               Date of Birth (dd/mm/yy): ________________________
 Section 2: Next of Kin-Details
 Name: ____________________________________                  Telephone No: _________________________________

 Email address: ______________________________               Relation to applicant: ___________________________

 Address: ____________________________________________________________________________________


 Course applying for: __________________________________ Course Code: ____________________________

 Accountancy (ACCA)                         Business Management (ABE)

 Course commencement date: ___________________________________________________________________

 Who will pay your fees? Please tick as appropriate.(attach evidence and letter from sponsor)

      Parents      Family member          yourself      Employer (please attach evidence)

      Others please specify ____________________________

Section 3: Educational Qualifications (including awaiting results with the most recent first)
    Title of Qualification               Institution           Date Awarded         Subjects Passed & Grades

Section 4: Employment Details
Give details of work experience, training and employment if relevant.

  Employer’s           Job Title   Full Time/          Job Description and main             Date       Date To
    Name                           Part Time                responsibilities                From

Section 5: English Language Proficiency (Please refer to guidance notes 1.1)
Is English your first language     Yes          No

Have you attended any courses in English Language         Yes (Please attach evidence)      No

Have you taken any English Language proficiency test       Yes (Please attach evidence)         No

Section 6: Personal Statement in support of application

All applicants – please produce a personal statement that describes your academic interests and your purpose
and objectives in undertaking this study. This is your opportunity to introduce yourself to the selectors. Please
describe your academic background, strengths/interests, ambitions/research interests, career aspirations etc in
support of your application. If you have been out of formal education for some time, please outline any relevant
experience that may be taken into account in lieu of formal qualifications. Please continue on a separate sheet if





Section 7: Referees

Please provide two academic references in support of your application. If you are currently working, we will
accept one professional reference in addition to one academic reference. The college reserves the right to
contact the referees to comment on your suitability and eligibility for the course you are applying for. Please
note that it is in your interest to obtain these references from your referees and forward those to the college to
further support your application.

Note to the applicant:

Please provide your referee’s name and contact details. Please refer to 1.3 of guidance notes on this form for
more information.

Referee 1                                                 Referee 2

Name:__________________________________                   Name:__________________________________

Organisation: ____________________________                Organisation: ____________________________

Position: ________________________________                Position: ________________________________

Address: ________________________________                 Address: ________________________________

________________________________________                  ________________________________________

Contact No: ______________________________                Contact No: ______________________________

Email: __________________________________                 Email: __________________________________
Section 8: Additional Needs

Do you have any disabilities, health related conditions or special educational needs?     YES/No

If yes please give brief details including medical evidence and any special provision you think may be required.
Please refer to Guidance notes 1.2




Section 9: How did you hear about LICM?

    Family                    Friends                University/College

    British Council            LICM Website          Education Fair*        Magazine/Newspaper*

    LICM Staff*       Other Website*       Other*

*If you ticked this option please give detail: ________________________________________________

No                                              Question                                               Yes   No

1     Are you aware of all the information and programmes offered by LICM?

2     Are you aware that LICM will not find any part time, full time or any placement service
      while you are studying here?

3     Are you aware of your total course fees and accept to pay the remaining fees (if any) as
      agreed by you and LICM?

4.a   Are you aware that the fee paid will only be refunded if a letter of refusal from the British
      Embassy and the original documents of admission issued by the college are attached with
      the refund application form and an administration fee of £200 will be applicable?

4.b Are you aware that you will not be refunded any fees if your visa is refused on the basis of
    your maintenance of funds or fake documentation that you have submitted?

4c    Are you aware that you have to request for the refund in any of the above cases within 7
      working days of your visa refusal and then this will be reviewed by the college within 6

4d    Are you aware that if the visa was refused on the basis of the CAS Issued by this college,
      then the applicant must apply for administrative review (appeal) within 28 days of the
      refusal, otherwise the student will not be entitled to any refund?

4e    Are you aware that you will not be eligible for any refund of fees if you are refused entry by
      the border agency at the airport?

5     Are you aware that attendance is compulsory and you must maintain a minimum of 80%
      throughout your course or you will be suspended from the LICM college and these may
      adversely affect your immigration status?

5a    Are you aware that you are required to attend minimum 15 hours of study per week?

6     Are you aware that you cannot change or defer the course without written permission
      from LICM in advance?

7     Are you aware that your total course fees do not include awarding body examination fees,
      registration fees with the awarding body or any other expenses that you might incur during
      your stay in UK? (i.e. they only include your tuition fees)

8     Are you aware that you should have sufficient funds to support yourself during you course
      of study in the UK, and must not depend on any part time jobs for the same?

9     Are you aware that you will incur an additional re sitting fee if you do not clear the modules
      in the first attempt?

10    Are you aware that LICM will inform the UKBA regarding your registration, attendance and
      progression details and if any information suggests that you are breaching the conditions
      of your leave than these will adversely affect your immigration status?

11    Are you aware that you MUST inform LICM of any changes to your personal circumstances

     or contact details?

12   Are you aware that LICM reserve the right to amend the Terms & Conditions at any time?

13   Are you aware that you give consent to LICM by signing this application form?

Section 11: Declaration

I declare that the statements on this form are correct. I understand that any offer of admission may be withdrawn if
I cannot provide documentary evidence of any statements on this form. I agree that college may process the
information contained in this form and retain it for five years for statistical and administrative reasons. If I am
admitted to the college I undertake to observe the college’s regulations and to ensure payment of tuition fees and
other financial liabilities to the college. I have read and understood the Terms and Conditions of the college.

Signature of Applicant ________________________________ Date _______________________

 Section 12: Checklist (For online application, please attach scanned copies of documents)

 Please attach all relevant supporting documents

        Copy of valid passport
        Passport size photograph
        Personal statement
        Letter of Financial Sponsorship along with Bank Statement
        Attested copies/transcripts of all Educational Qualification
        Copies of English language certificates
        Original Reference letters on official letter headed paper
        Experience letter from the employer (if applicable)
        Medical Certificate for any disability mentioned

              The college will not review applications until all supporting
                                       Documents are received

Guidance Notes

       Before completing your application you should read the College literature relating to the
        course(s) for which you are applying. You are advised to access the online prospectus on our
       If handwritten, please complete the form in block capitals using black ink, and in legible
       Please complete all fields; if a field is not relevant to you write N/A (not applicable).
       Please make sure you give us your correct contact details including email address as this will be
        the main medium of communication with most of the students.

1 Required English language Levels

       It is important that you can demonstrate a suitable level of English language proficiency before
        commencing on a course at LICM.
       English Levels are assessed according to the requirements of UK government, accreditation
        agencies and awarding bodies.
       English language requirements are IELTS6/6.5.


       The college is fully committed to the implementation of a disability policy to achieve equal
        opportunities for all students.
       In order that we can provide appropriate support for disabled students, it is important that any
        additional needs are outlined at the time of application.
       Applicants who indicate support may be invited to discuss these in further detail, if


       The referee's report is an important part of the admission process. The information it contains
        helps College staff in making decisions about admissions.
       The reference letter should be provided on the official letter headed paper of the Educational
        institution, and/or Employer.
       Referees should be able to comment on previous/present/likely performance, abilities, and
        intentions of the candidate in the context of candidates’ academic and career ambitions, and
        his/her suitability for the course applied for.

4 Transcripts

       Candidates should send us the attested copies of all their educational certificates/transcripts.
       Candidates should make sure that these transcripts are duly attested by the awarding body or
        British Council/embassy/high commission of their country.
       If your transcripts are not in English, we must receive official independent translations bearing
        the stamp/signature of the translator.
       Candidates should note that at the time of enrolment, they should have to bring the original
        transcripts and all other relevant documents for verification.

For Office Use Only
The admissions process for all the concerned departments to follow in the below order

Received & Checked by Admissions: ______________________              Date: _______________________

Comments: _________________________________________________________________________________

Assessed for Interview:       Accepted/Rejected      Forwarded to Academics on/by: ___________________

Interviewed by: ________________________     Date: ______________            Accepted/Rejected

Comments: ________________________________________________________________________________

Forwarded to Admissions for authentication on/by: ___________________________Successful/Unsuccessful

Comments: __________________________ ____________________________________________________

Conditional Offer Letter issued by: ______________________            Date: _________________________

Comments: _________________________________________________________________________________

Forwarded to Finance for fees on/by: _______________________________Approved/Rejected

Forwarded to Admissions on/by: __________________ CAS recommended by __________________________

Forwarded to Authority for CAS on/by _______________CAS Issued by/on_____________________________

Forwarded to Admissions by/on: ________________ Unconditional offer issued by/on____________________

Comments: _________________________________________________________________________________

For Accounts Use Only

Receipt No:                                          Course Code: __________________________________

Application No: _______________________________

Total Amount: £ ______________________________       Amount Paid: £ _________________________________

Balance: £ ___________________________________

Mode of Payment:      Cash         Cheque            Debit Card           Credit Card     Bank Transfer

Other: ______________________________________        Cheque No (if applicable): ________________________

Date payment received: ________________________

Payment received by: __________________________ Date: ________________________________________

Remarks: ____________________________________________________________________________________

Payment authorised by: _________________________ Date: _________________________________________

Signature: ___________________________________       College Stamp:


Shared By: