International Admissions

Application Form
Taught programs

Please complete all sections carefully in BLOCK CAPITALS in black or blue ink, and attach certificates / other required documentation. You can also
apply online for all courses; www.anglia.ac.uk/apply. Failure to complete this form in full will result in your application being delayed and it may
not be considered within our advertised processing times.

1. NAME & ADDRESS

Title: Mr/Mrs/Miss/Ms/Other

Date of Birth (dd/mm/yyyy) _ _ /_ _ /_ _ _ _ Male

Female

First/Given name(s) .....

Surname/Family name .
Previous Surname/Family name (if applicable)
If you have previously applied to / studied with Anglia Ruskin University please provide your Student ID _ _ _ _ _ _ _ / _
Have you applied via UCAS? Yes
No
if yes please provide your UCAS Personal ID: _ _ _ _ _ _ _ _ _ _
Home Address (where you are ordinarily permanently resident):
Correspondence address if different (eg Agent, Temporary UK):
House name/number ... House name/number ...
Street.. Street..
City/Town City/Town
Country .. Country ..
Postcode Postcode
Tel (inc code). Tel (inc code).
This will be the main method of communication with applicants, please ensure details below are legible and accurate.
Mobile telephone number .............................................................................................................................................
Personal Email address ...............................................................................................................................................

2 . COURSE OF STUDY APPLIED FOR:

Course Level: Undergraduate
Study Mode: Full time

Postgraduate

Part time

Location: Cambridge campus

Course Name:

Distance learning

Chelmsford campus

Start date:

September

January _ _ _ _ Year

Peterborough campus

If you are applying for advanced entry (APL) to an Undergraduate Course please indicate year of entry: Yr2

Yr3

3. NATIONALITY & IMMIGRATION

What is your Nationality? (As stated on your passport)
In which country were you born?
In which country do you currently live?
Have you ever or applied to: enter / remain / reside / live in the United Kingdom (UK) and / Yes
or European Union (EU)?

No

If yes go to 3a if no go to 3b

3a. IMMIGRATION
Have you ever been refused entry or leave to remain in the UK or EU?

Yes

No

Have you ever previously studied in the UK?

Yes

No

Do you have a current / pending Visa application to (enter or leave to remain in) the UK?

Yes

No

If you have answered yes to any of the questions in section 3a you must provide copies of your passports / Visas / CAS
Statements / visa letters / exit stamps / refusal letters / relevant correspondence. Now proceed to section 3b.
3b. FEES INFORMATION You must give details of who will be paying your fees. A sponsor is defined as a company or other organisation and
does not refer to a private individual, such as a member of your family. If sponsored please attach a copy of your sponsor letter, if available
Who will pay your fees?

Yourself

Sponsor

Sponsor Name:

For Anglia Ruskin University use only - Date received:

SID:

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4. EDUCATION: Please list all completed, partially completed and pending qualifications in date order (most recent first). Please ensure
that copies of your certificates and transcripts are provided with your application; including official translations if qualifications are not in English . If
applying for advanced entry (APL) please provide copies of official transcripts, a list of pending modules (with associated credit weightings if
applicable) and your syllabus. For more information on APL at Anglia Ruskin University please go to: www.anglia.ac.uk/apl
Institution
(including location)

Subject

Level
Grade
(eg IGCSE, IB, BA, MSc)

Achieved / Date
Predicted (mm/yyyy)

4a. ENGLISH LANGUAGE QUALIFICATIONS: Please provide details of achieved and pending qualifications / tests.
Title of qualification
(eg O Level, IGCSE, TOEFL, IELTS)

CEFR Level Grade (including scores for individual skills if

(eg B1, B2, C1) applicable)

Are you intending to undertake English Language studies with

Anglia Ruskin University before commencing your degree programme?
Yes
For more information upon our English Language programs please go to: www.anglia.ac.uk/efl

Verification ID
(if applicable)

Date
(mm/yyyy)

No

5. EMPLOYMENT: Please give details of current and previous employers, with dates. If the course you are applying for requires
professional/work experience as part of the entry criteria, please provide curriculum vitae (CV) / resume which should include an outline of the
responsibilities associated with each position.
Please tick here if you have attached Curriculum Vitae on a separate sheet
Organisation

Position held

Dates
From (mm/yy) To (mm/yy)

6. PROFESSIONAL REGISTRATION
If you are a member of a professional body (ACCA, NMC, GMC etc.) please provide your membership details below
(Please provide copies of your registration documents with your application):
..

7. PORTFOLIO A number of our courses require a portfolio to be assessed (for example Architecture and Arts courses),
please ensure that you have checked the entry requirements of the course before you apply. Full details of our entry
requirements can be found here www.anglia.ac.uk/courses
Please tick here if you have attached a copy of or provided a link to your online portfolio
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8. STATEMENT OF PURPOSE IN SUPPORT OF APPLICATION: This section must be completed for all
applications, failure to do so will delay your application. It may not be considered within our advertised processing times. Please note that
this section may be provided to third parties, including the United Kingdom Border Agency (UKBA) upon request.
Please tick here if you have attached a Statement of Purpose on a separate sheet
You should state why you want to undertake this course: provide information on your previous academic and professional studies and how this course
will enable you to develop further, give details of any relevant experience (including paid and voluntary work), and outline the skills and attributes which
make you suitable for this course and your long term goals.

Continue on a separate sheet if required

9. REFERENCE: All applicants must provide one recent reference. References must be written within the last 6 months and provided
on letter headed paper, signed and dated. The referee should be a course tutor if you have been in education within the last two years or your
current or most recent employer. Candidates applying on the basis of work experience must provide at least one reference from their most recent
employer. The referee should not be a friend or family member.
Name of referee 1 .................................................................... Name of referee 2 ....................................................................
Organisation ............................................................................. Organisation .............................................................................
Course Tutor

Line Manager

Course Tutor

Line Manager

Reference attached

Reference to follow

Reference attached

Reference to follow

10. LEARNING SUPPORT REQUIREMENTS: Please complete this section if you have any disability, medical condition or
specific learning difficulty. If you require further advice please contact Student Services at Anglia Ruskin University.
www.anglia.ac.uk/studentsupport
Do you have a disability, medical condition or specific learning difficulty? Yes

No

If yes, please name the condition and give brief details; our Student Support Service will contact you to discuss any support
needs.
.................................................................................................................................................................................
.................................................................................................................................................................................
Continue on a separate sheet if required
Please tell us where you found out about this course
Website

Advertisement

Agent

Fair

Other

Please provide further details (e.g. name, location, date)

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11. DECLARATIONS
11a. Do you have any unspent criminal convictions?

Yes

No

A criminal record will not necessarily be a bar to obtaining a place at Anglia Ruskin University.
A satisfactory Disclosure and Barring Service (DBS) report will be required for successful applicants to courses which
include placements where students work with children or vulnerable adults.
11b. Data Protection Act 1998
I agree to the University processing personal data contained in this form or other data which the University may obtain from
me or other people. I agree to the processing of such data for any purposes connected with my studies or my health and
safety whilst on the premises or for any legitimate reason including communication with me following the completion of my
studies.
In addition, I agree to the University processing personal data described as Sensitive Data within the meaning of the
United Kingdom Data Protection Act 1998, such processing to be undertaken for any purposes as indicated in the
declaration above. If my employer/sponsor is supporting my studies by paying my fees/allowing me study time I agree to my
employer/sponsor being informed of the progress of my application and of my studies if I am accepted onto the course.
11c. Agent Referral and Nominated Access
To be completed if applying with the assistance of a recruitment agent or if you are likely to be away at any time and
wish to nominate someone who can make decisions on your behalf and discuss your studies with us. Please enter the full
name(s) of your nominee and their relationship to you.
I confirm that I give the following person(s) authorisation to discuss my application and/or studies with staff at Anglia Ruskin
University, and receive correspondence from Anglia Ruskin University on my behalf.
Relationship/company .................. Name
Email . Telephone Number
11d. Declaration
I certify that, to the best of my belief, the information I have provided is complete and true. Please note if any information is
withheld or misrepresented, we reserve the right to withdraw your Application and / or any Offer made.
Signature of Applicant

Date

Signature of Guardian
(if applicant is under 18 years)

Date

Please return this completed form with copies of the documentation required by email attachment to
internationaladmissions@anglia.ac.uk or by post to Anglia Ruskin University, International Admissions, Bishop Hall Lane,
Chelmsford, Essex, CM1 1SQ

12. CHECKLIST: Please ensure that you completed sections 1 to 12 of the application and have attached and provided all the documents
listed below.
Nationality & Immigration Documents (specified in section 3)
Qualifications (specified in section 4 and 4a)

For Anglia Ruskin University use only

Offer

Yes

No

Professional Registration / Portfolio (specified in section 6 & 7)

Statement

Yes

No

Statement of purpose (specified in section 8)

Academic

Yes

No

English

Yes

No

Reference

Yes

No

References, if available (specified in section 9)

Learning support requirements, if required (specified in section 10)
Declarations (specified in section 11)
I can confirm that all sections 1 to 12 have been completed

Other
IAO / CDM
OLB Codes

For more information about Anglia Ruskin University please go to: www.anglia.ac.uk/international

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