Fee Status Assessment Form

FEE STATUS ASSESSMENT FORM

As the University College of Osteopathy is a publicly funded educational institution, it charges two levels of fee: a lower ‘home’ fee and a higher ‘overseas’ fee.

Whether you pay a ‘home’ or ‘overseas’ fee depends on whether you meet certain criteria.

For guidance, please contact the UK Council for International Student Affairs (UKCISA) and refer to the following website:

http://www.ukcisa.org.uk/International-Students/Fees--finance/Home-or-Overseas-fees/England-Higher-Education/

Please complete the following form and e-mail to along with a black and white copy of the personal details page of your current passport. Please also provide black and white copies of all visas and stamps and any other relevant documents to help us assess your fee status.

Please note that you must provide all your original documents on Enrolment Day.

Course applied for: Choose an item.

Entry: Choose an item.

UCAS/Student Reference Number (if applicable): Click here to enter text.

1.  Personal information

Family name:
Click here to enter text. / Given names:
Click here to enter text.
Previous surname (if applicable):
Click here to enter text. / Date of birth (dd/mm/yyyy):
Click here to enter text.
E-mail:
Click here to enter text. / Country of birth:
Click here to enter text.
Correspondence address:
Click here to enter text. / Home address:
Click here to enter text.
Nationality (Citizenship):
(If you or your family have more than one citizenship, please list them all).
As shown on your/your parents/spouse/civil partner passports.
Click here to enter text.
Your Nationality/Citizenship:
Click here to enter text. / Nationality(ies) of family members:
Mother:
Click here to enter text.
Father:
Click here to enter text.
Spouse/civil partner:
Click here to enter text.

2.  Immigration status

Please note that you must provide your original passports and documents on Enrolment Day.

Please select the option that applies to you and give the dates as requested: / Please provide the following with returned questionnaire:
☐ British Citizen or British Overseas Territories Citizen or Commonwealth National with Right of Abode / Copy of relevant page(s) of passport (including page(s) confirming name and nationality)
☐ Indefinite Leave to Enter/Remain / Copy of relevant page(s) of passport (including page(s) confirming name and nationality) and/or Home Office letter
☐ Refugee status
Please indicate whether as refugee, spouse or civil partner of refugee, child or dependent of refugee
Click here to enter text. / Copy of Home Office letter or refugee travel document
☐ Refused refugee status (or child or spouse of someone refused refugee status) but granted one of the following:
☐ Exceptional leave to Enter/Remain
☐ Humanitarian Protection
☐ Discretionary Leave / Copy of Home Office letter
☐ Time limit on stay
Date last passport stamp/visa was issued:
Click here to enter text.
Date of expiry of most recent permission to stay: Click here to enter text. / Copy of relevant page(s) of passport (including page(s) confirming name and nationality)
☐ EEA national, or EU overseas territory national (does not include UK)
(EEA members: Austria, Belgium, Bulgaria, Croatia, Republic of Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain and Sweden)
☐ OR a Swiss national / Copy of relevant page(s) of passports
(including page(s) confirming name and nationality)
If none of the above categories covers you, or your status is likely to change before the start of the course, please give details and provide supporting evidence: / Click here to enter text.

3.  Residency history

Date of first entry into the UK (if applicable): Click here to enter a date.

Date of first entry into the EEA (excluding the UK) (if applicable):

Click here to enter a date.

Please give details about countries in which you have been resident, and the reasons for residence in the last three years:

Country of residence / Date from
(dd/mm/yyyy): / Date to
(dd/mm/yyyy): / Purpose of residence (e.g. education, vacation, living with family, employment)
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Please continue on a separate piece of paper if necessary

4.  Temporary residence abroad

If you have been ordinarily resident outside the UK and Islands (Channel Islands/Isle of Man) or EEA during the last three years because you, your spouse/civil partner or your parent(s) was temporarily working abroad, please complete this section. Please include copies of employment contracts.

Country / Length of stay (including arrival and leaving date) / Employer and nature of work / Contract type
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Please continue on a separate piece of paper if necessary

Do you pay tax contributions in an EEA country?

☐ Yes

☐ No

If ‘Yes’, please give details Click here to enter text.

Was/is a house or flat maintained in the EEA during the period of employment abroad?

☐ Yes

☐ No

If ‘Yes’, please give details including address, length of possession and provide proof of ownership (i.e. utility bills, deeds of purchase, etc.)

Click here to enter text.

5.  Education history

Please tell us about your education history:

School/ College/ University / Town & Country / Date from
(dd/mm/yyyy): / Date to
(dd/mm/yyyy): / Full-time?
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Please continue on a separate piece of paper if necessary

6.  Marriage and Civil Partnership

If you are not a British Citizen, EEA National or Swiss National, or do not have indefinite leave to Enter or Remain in the UK, please complete the following (if applicable):

☐ I am married or in a civil partnership (If you tick this box, please supply proof and answer the questions below)

Are you married to/in a civil partnership with:

·  a British Citizen ☐ Yes ☐ No

·  an EEA or Swiss national ☐ Yes ☐ No

·  someone who has Indefinite Leave to Enter or Remain in the UK ☐ Yes ☐ No

·  Other (please give details):

Click here to enter text.

Date of marriage/civil partnership (dd/mm/yyyy): Click here to enter a date.

Please provide:

A copy of relevant page(s) of passport (including page(s) confirming name and nationality) of your spouse/civil partner and/or a Home Office letter confirming their status in the UK.

7.  Working in the UK

If you are a non-British EEA national, or Swiss national, or the child of a Turkish national ordinarily resident in the UK, or a British national who has worked in another EEA country, or the spouse/civil partner or child of such a person, please complete the following:

Are you currently resident in the UK or EEA? ☐ Yes ☐ No

If ‘Yes’, please complete the table below providing details of you, your spouse/civil partner or your parents’ current and previous work in the UK:

Please supply details of all recent employment

Self/Spouse/Civil Partner/Parent / Type of work / Dates from
(dd/mm/yyyy) / Dates to
(dd/mm/yyyy)
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Are you, your spouse/civil partner or parents currently looking for work in the UK?

Yes ☐

No ☐

Use this space to give details or any other relevant information:

Click here to enter text.

8.  Refugee/asylum in the UK

Please complete this section if applicable.

When did you first apply for asylum in the UK Click here to enter a date.

Please check all statements that apply to you and provide any further details:

☐ I have Refugee Status

☐ My Parent(s)/Guardians have Refugee Status

☐ My Spouse/Civil Partner has Refugee Status

☐ I am an asylum seeker and I am awaiting a decision from the Home Office or the result of an appeal

☐ I have Exceptional Leave to Enter or Remain in the UK

☐ I have been granted Humanitarian Protection in the UK

☐ I have been granted Discretionary Leave in the UK

☐ I have been given the right to stay indefinitely/settlement in the UK within the last three years

☐ Refused refugee status but granted one of the above

If you have been given the right to stay indefinitely in the UK when were you given this? Click here to enter a date.

9.  Other information

If there is other information that will assist us making our assessment, please indicate that you have enclosed separate attached information by ticking this box ☐

10.  Checklist

☐ I have completed sections 1, 2, 3 and 5 (compulsory)

☐ I have completed section 4 (if applicable)

☐ I have completed section 6 (if applicable)

☐ I have completed section 7 (if applicable)

☐ I have completed section 8 (if applicable)

☐ I have enclosed all relevant documentation

☐ I have provided extra information

Please enclose photocopied evidence in support of your assessment. This will help us assess your status promptly and correctly.

11.  Declaration

By checking this box or signing I hereby confirm that the information provided above is correct to the best of my knowledge ☐

Signature (if returned in hard-copy):

Name: Click here to enter text.

Date: Click here to enter a date.

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01/08/2017