International Student Application Form

Please return the completed form to: International Admissions

University of Bedfordshire
University Square, Luton, Bedfordshire LU1 3JU United Kingdom
T: +44 (0)1582 489326
Tier 4 Sponsor F: +44 (0)1582 743469
Licence Number DA8AR2CH7 international@beds.ac.uk

Please read the notes at the back before completing this form. It is important that you write neatly using BLOCK CAPITALS in black ink or
typescript. If available, you must include a copy of the personal details page from your passport (the page that contains the passport
number and your photo). Incomplete application forms submitted without ALL the supporting documents may delay the issuing of your
offer.
*Signing this box indicates you are giving your consent for us to store and process the
Applicant signature* information you supply on this form, including all personal details in accordance with
the Data Protection Act 1998. We cannot process your application without your informed
consent which means that we will be unable to assess or respond to your application.

1 Personal Details
Title (Mr/Mrs/Miss/Ms etc) Male Female Date of birth* (dd/mm/yyyy) 29/06/1991

First name(s) ISNAN

Family name(s) HASIB
Previous family name (if changed)

Passport number and country of issue

Correspondence address Permanent/Home address (if different)

82 OUTER CIRCULAR ROAD, MOGHBAZAR 82 OUTER CIRCULAR ROAD, MOGHBAZAR

Postcode 1217 Postcode 1217

Telephone (including international code) Telephone (including international code)

Mobile (including international code) +8801955273989 Mobile (including international code) +8801955273989

Current email Skype ID

Do you have any criminal convictions? Yes No

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? Yes No

2 Fee Status and i ration History

Country of birth BANGLADESH Present nationality BANGLADESHI
Country of Domicile BANGLADESH
Are you currently resident in the UK? Yes No Have you ever been refused a Visa to any country? Yes No
Do you intend to bring any dependants Have you been denied entry to the UK before?
es o Yes o
to the UK with you?
Have you studied in the UK previously? Have you ever overstayed any type of UK Visa
es o granted to you? Yes o
If yes, provide details below.

UK Visa Number Visa Type Valid From Valid To Institution

JTV6VB659 Tier 4 Student 15.08.2010 31.11.2011 University of Oxford
EXAMPLE EXAMPLE EXAMPLE EXAMPLE

www.beds.ac.uk/international September 2017

 3 Agent Details (to be completed if applying through an Agent)
Agent (Code) Email
Contact name Telephone (including international code)
Agent address

Country Postcode

4 Details of Course(s) for which you wish to Apply

If you require UG
Course title Undergraduate (UG) Advanced Level Entry –
or please state Level 2 or 3 Month/year
Postgraduate (PG)? (complete Section 4a) of entry
Choice 1:
Choice 2:
Choice 3:

4a To be Completed for Entry on to Degree Level 2 or 3

Please include a transcript (detailed mark certificate) of all units of learning successfully studied, as well as detailed information
which clearly states what curriculum was covered in each unit of learning. To confirm the units for your University of Bedfordshire
programme, please check the relevant course page on our website: www.beds.ac.uk
Please tick which of the following you are including as evidence to support your claim (claims will not be considered without the
required evidence):
official certificates and transcripts unit outcomes/objectives assessed coursework/project work
unit descriptor unit syllabus marked examination papers

5 Full Academic History and Qualifications

Please list results, including those which are pending. Please attach photocopies of your certificate, transcripts, copies of all UK
Visas, copies of previous CAS', enrollment letters, and student status letters. You must give details of every institution at which
you have studied even if you did not receive an award from that institution.

Name of ro ra NQF Start Date End Date o you a a

institution o tudy Level i of Course of Course urtail nt l tt r
studi d is is a l tt r
ro t to
in t say t at you a If yes
an isa iry please provide
dat If yes please
copy of letter
provide copy of
letter

University of
Foundation 3 15.01.2012 20.12.2012
Oxford course in
E X A M P L English
E EXAMPLE EXAMPLE

www.beds.ac.uk/international September 2017

 6 English Language Requirements
Please complete this section. It is very important to provide all the relevant details to enable us to assess your English level and
determine whether you meet our entry level criteria in English. You will be required to provide evidence of your English level.

Do you have any of the English qualifications listed below? (please tick all that apply):
IELTS CAMBRIDGE GCSE PEARSON TEST NONE
Other (please give details)

Grade / score

Date achieved

7 Personal Statement and Work Experience

Applicants are required to provide a personal statement in support of their application. On a separate piece of paper please state
your reasons for choosing this course. Include details of any relevant experience and your career plans. Please also attach any
other relevant documents detailing your work experience, such as your CV. In order for your application to be processed your
personal statement must explain why you want to study in the UK, why you wish to come to Bedfordshire, why you
have chosen your course, and how it will help you fulfill your career goals.

8 Physical or other Disability or Medical Condition

Do you have a disability or any condition which might necessitate special arrangements or facilities?
Yes No
If Yes please provide details on a separate sheet of paper.

9 How did you hear about us?

Agent University website Exhibition Search engine

Website / Online directory listing (please specify)

Social Media website (please specify)
Other (please specify)

10 References
Names and addresses of two referees (the University may contact referees if required).
Name Name
University/Company University/Company
Address Address

City City
County County
Postcode Postcode
Telephone (including international code) Telephone (including international code)
Mobile (including international code) Mobile (including international code)
Email Email

11 Declaration
I confirm that, to the best of my knowledge, the information given in this form is correct and complete. I grant permission to
the University of Bedfordshire to request information pertaining to my current or previous visa status in the UK from the
Home Office if e e

Student Name (please print):

Passport number: Date of Birth: 29/06/1991

Signature: Date:

www.beds.ac.uk/international September 2017

 Notes for Guidance
General
Before completing the form, please ensure that you read these notes If you feel your professional experience makes you eligible for advanced
carefully. You should also read the current University of Bedfordshire entry please submit evidence.
literature relating to the course(s) in which you are interested. If you wish to indicate an order of preference for your course choices
you may do so. If you do not indicate an order of preference then it will be
assumed that you have none.
The Data Protection Act 1998
The information which you give on your form will be used for the Section 5 Academic History
following purposes:
Enter the exact subject name used by the examining body and the name
• To determine your eligibility for entry to the University of Bedfordshire. of the examining body in full. If you have qualifications obtained outside
• To enable the University of Bedfordshire to compile statistical reports. the UK, you should give details of all examinations taken as preparation
• To enable the University of Bedfordshire to initiate your student record. for entry to higher education (eg School and Higher School Certificate,
Apolytirion, Baccalaureat). Applicants with qualifications obtained in a
• To share information with government departments (eg immigration language other than English, must attach a certified English transcript to
office), local authorities and other bodies to prevent possible fraud and to the form.
enable them to carry out their functions.
Section 8 Disability/special needs
Section 1 Personal details Describe your condition and, where it is not obvious, indicate whether
Complete this section in BLOCK CAPITALS. Passport Number - If you do you have special needs.
not have a current valid passport you will need to apply for one. Without a
passport we will not be able to issue you with an Unconditional Offer nor Section 10 References
will you be able to apply for a visa. Pease supply the name and contact details of an academic reference
from your current or previous studies. This need not be related to the
Section 2 Fee status course you are applying for. We will contact referees if required.
Please state your country of permanent residence and give details of If you are applying for an MBA you may need to submit a professional
who you expect to pay your fees for the proposed course. reference.
Please see unibeds.info/MBAAD for more details.
Section 4 Details of course(s) for which you wish to apply
Level of Entry – If you qualify for advanced entry to your chosen course
of study please submit your current academic qualifications such as a
transcript. Please also submit, where possible, the relevant unit's
syllabus.

DOCUMENT CHECKLIST - DO NOT SEND ORIGINAL DOCUMENTS

Please make sure you include the following documents with your application
Application Form

Copies of your Academic Certificates/Transcripts

Copy of your English Language Examination Results

Copy of current passport

Personal Statement including why you want to study in the UK, why you have chosen
Bedfordshire, why you have chosen your course and how it will help fulfill your career goals

Previous visa and visa refusal documentation

www.beds.ac.uk/international September 2017