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V9. 111209
UGUndergraduate Application / Agent or University official stamp – please state where direct
Direct Application Form for International Students
This form may be printed or photocopied, please write in black ink.Please affix official stamp where appropriate, at the end of the statement.
SOLELY FOR APPLICATIONS NOT HANDLED BY UCAS
THE UNIVERSITIES AND COLLEGES ADMISSIONS SERVICE OR OTHER CLEARING HOUSES.
Please read the accompanying Notes for Guidance before completing this form.
Please complete all sections. If a section is not applicable, write N/A.
Please return the completed form and relevant documents to the:
Admissions Department
University of Lincoln
Brayford PoolTelephone+44 (0)1522 886097
LN6 7TSInternet
United Kingdom
Personal Details
1 Title (Mr, Mrs, Ms, Miss etc)
2 Full Name / First/Given Names
Surname/Family Name
3 Preferred First Name/Given Name
4 Previous Surname/Family Name
(if changed)
5Gender
Please select as appropriate / Male
Female
6Date of Birth
(DD/MM/YYYY)
7 Permanent/HomeAddress / Address
Post Code (if UK)
Country
8 Correspondence Address
( If different) / Address
Post Code (if UK)
Country
9 Email Address
If applying through an overseas agent please also provide your personal email address and agent email address.
10 Contact Telephone
(Please remember your country code)
11 Mobile Telephone
(Pease remember your country code)
Course you wish to apply for
12 Course Title13Start Month and Year
14 Stage – year of entry / Full Time
Part Time
15 Please tell us where you heard about this course
Language Qualifications
16 Language Qualifications (if English is not your first language)e.g. IELTS, TOEFL
17 Results, Grades, Marks
18 Date Obtained
19 Institution
Academic Qualifications
20Please give details of all your academic qualifications. Continue on a separate sheet if necessary.
Qualification / Subject / Date Obtained(Month & Year) / Institution and
Place of Study / Results
Grades, Marks, Degree Class etc. / Please Indicate Highest Qualification
Career History
21 Please give details of work experience, training and employment. Continue on a separate sheet if necessary.
Job Title / Employer / Full TimePart Time / Brief Description of Responsibilities / From
Month Year / To
Month Year
Supplementary Information
22 Country of Birth23 Nationality
24Country of Permanent Residence if different from your country of birth
25 Have you resided in the country of permanent residence as stated above for the past three years or more?
Please select as appropriate / Yes
No
26If yes above:
For what purpose?
Please select as appropriate / Study
Work
Family
Place of Birth
Other (please state)______
28 Please indicate any physical or other disability or medical condition including any which may necessitate special arrangements or facilities
Please select as appropriate / Please tick which of the following apply:
0. You do not have a disability nor are you aware of any additional support
requirements in study or accommodation
------
1. You have dyslexia
2. You are blind/ are partially sighted
3. You are deaf/ have a hearing impairment
4. You are a wheelchair user/ have mobility difficulties
5. You need personal care support
6. You have mental health difficulties
7. You have an unseen disability, e.g. diabetes, epilepsy, asthma.
8. You have two or more of the above disabilities
9. You have a disability not listed above
29 Have you ever been convicted of a relevant* criminal offence
Please select as appropriate / Please tick ONE of the following: Yes No
* Relevant criminal convictions are only those convictions for offences against the person, whether of a violent or sexual nature, and convictions for offences involving drugs, firearms, arson and terrorism. Convictions that are spent (as defined by the Rehabilitation of Offenders Act 1974) are not considered to be relevant. However, certain courses, for example health or social work related, do not come under the Rehabilitation of Offenders Act and should therefore be declared.
30 Please state how your tuition fees will be funded
Please select as appropriate / Self Funded
Sponsor
Other (please state)______
Personal Statement
31Personal StatementPlease summarise your academic interests and reasons for choosing your proposed course of study. We recommend that that you write between 200 and 400 words.
Referees
References should be submitted with your application.
Note: At least one of your referees should be able to comment on your most recent academic performance
32 Name of First Referee33 Address / Address
Post Code (If UK)
Country
34 Email
35Telephone Number
36 Name of Second Referee
37 Address / Address
Post Code (If UK)
Country
38 Email
39Telephone Number
Additional Information Required
Please check you have included the following items and return your completed application to the address noted on the front of this form:
Copy of highest qualification certificate;
Copy of highest qualification transcript;
Copy of English Language qualification(s) certificate(s) if English is not first language;
If you will require a visa to enter the UK, please include a copy of your passport;
Should you require further details on the items to include, please contact the Admissions Department for additional guidance via telephone +44(0)1522886097 or email .
Declaration
I confirm that, to the best of my knowledge, the information given in this form is correct and complete. I also understand that in accepting any offer of a place I might receive I agree to abide by the rules and regulations of the University of Lincoln. I also understand the terms and conditions of application specified in the prospectus, including that the University does not undertake any absolute obligation to provide educational services in the manner specified in the prospectus or in any other document. I will provide original certificates on or before enrolment to confirm my existing academic qualifications.
______
SignatureDate
Notes for Guidance
The Data Protection Act 1984
The information which you give on your application form will be used for the following purposes only:
- To enable your application for entry to be considered
- To enable the university to compile statistics, or to assist other organisations or individual research workers to do so, provided that no statistical information which would identify you as a person will be published.
- To enable the university to initiate your student record Your application form will be photocopied before it is sent to admissions tutors and it is therefore important that you write neatly using black ink or typescript.
Relevant criminal convictions
Relevant criminal convictions are only those convictions for offences against the person, whether of a violent or sexual nature, and convictions for offences involving unlawfully supplying controlled drugs or substances where the conviction concerns commercial drug dealing or trafficking. Convictions that are spent (as defined by the Rehabilitation of Offenders Act 1974) are not considered to be relevant and you should not reveal them (but see the next paragraph).
If you are applying for courses in teaching, health, social work and courses involving work with children or vulnerable adults, you must tell us about any criminal convictions, including spent sentences and cautions (including verbal cautions) and bindover orders. For these courses, you may need an ‘enhanced disclosure document’ from the Criminal Records Bureau or the Scottish Criminal Record Office Disclosure Service.
Declaration
Any offer of a place you may receive is made on the understanding that in accepting it you agree to abide by the rules and regulations of the University of Lincoln, and by signing this form you are confirming your agreement to this.
Important note
All students will be required as a condition of enrolment to abide by, and to submit to University’s Regulations as amended from time to time. A copy of the current regulations is available, on request, from the university.
The university will use all reasonable endeavours to deliver courses in accordance with the descriptions set out in the prospectus or other course information. However, the university does not provide education to UK undergraduates on a commercial basis. It is also very largely dependent upon charitable and public funds, which the university has to manage in a way which is efficient and cost effective, in the context of the provision of a diverse range of courses to a large number of students. The university therefore:
- reserves the right to make variations to the contents or methods of delivery of courses, to discontinue courses and to merge or combine courses, if such action is reasonably considered to be necessary by the university. If the university discontinues any course, it will use its reasonable endeavours to provide a suitable alternative course.
- undertakes to take all reasonable steps to provide educational services in the manner set out in the prospectus and in other documents. Should industrial action or other circumstances beyond the control of the university interfere with its ability to provide such services, the university undertakes to use all reasonable steps to minimise the resultant disruption to educational services.
The university does not undertake any absolute obligation whatsoever to provide educational services in the manner specified in the prospectus or in any other document, nor does it undertake any other obligation in respect of the provision of educational services which is more onerous than the obligations set out herein.
cannot accept responsibility, and expressly excludes liability, for damage to students’ property, transfer of computer viruses to students’ equipment, liability for breach of contract, etc.
Notes for the guidance of referees
The referee’s report is an integral and important part of the selection process, and the information you give will help to guide admissions tutors in making their decisions.
In order that the university can evaluate an applicant’s academic and intellectual capacity, your reference should if possible cover:
- Suitability for the course applied for.
- Intellectual qualities including: (a) development to date and previous examination performance with special reference to any factors which may in your opinion have adversely influenced the result; (b) present performance; (c) potential, including an assessment of the probable results of any pending examinations.
- Personal qualities.
- Career aspirations.
- Health and other personal circumstances relevant to the application.
- Athletic, social and other interests.