International Application Form: Section 1: Your Course

International Application Form
Please complete ALL sections of this form clearly AND ACCURATELY.

If information is missing we will not be able to process your application.
Please email your completed application and supporting documents to [email protected]
Section 1: Your course

Full title of course (including Foundation, BA/BSc, MA/MSc):
Month and Year of Entry: How do you wish to study?
September January 20 Full-time Part-time* Distance

learning
*Please note part-time options are not available to Tier 4 applicants.
Section 2: Your personal details

Your first name (as written in your passport): Your surname (as written in your passport):
Your title:
Mr Mrs Miss Ms Dr Professor Other
Gender: Date of birth (DD/MM/YYYY):
Male Female
Country of birth: Nationality:
Permanent postal address (Including country/postal code): Your personal mobile number (Including country code):
Your personal email address:
Section 3: Visa
Which country are you currently living in? Will you require a visa (Tier 4 or student visitor) to study in UK?
Yes No
If you were not born in the UK, when did you last enter the UK (MM/YYYY)?
Have you previously been refused a visa application to the UK? Yes No
Section 4: English language qualification
Qualification/Name of Test:
Overall result (Please state the highest English Language Qualification that you have currently. Valid
qualifications include GCSE English (grades A - C), IELTS or equivalent):
Section 5: Academic history

Your education in your home country normally from the age of 16 (e.g. high school, A level, etc), starting with the
most recent qualification first.
Date started Date finished Examinations taken and

Schools attended MM/YYYY MM/YYYY qualifications obtained Grade
It is important you give information about any studies you have undertaken in the UK and any previous tier 4
visas. If you do not, it may prevent you obtaining your Visa. Please attach copies of previous Visas and provide
details of the course you studied, the dates and the institution.
Date started Date finished Examinations taken and

Institution attended MM/YYYY MM/YYYY qualifications obtained Grade
Please attach copies of previous Visas/CAS and provide details of the course you studied, the dates and
the institution.
Section 6: Other information
You must inform us about any convictions you have that are not ‘protected’ as defined by the Rehabilitation of Offenders
Act 1974 (Exceptions) Order 1975 (as amended in 2013).
Do you have an unspent conviction? Yes No
The University welcomes applications from disabled international students and we encourage you to declare your
disability and your support needs as soon as possible. Telling us about your disability will not affect your selection as a
student, but will enable us to work with you to assess your needs, plan your stay at the University and inform you to what
extent we can meet your requirements.
Do you have a disability or medical condition that require any additional support? Yes No
Section 7: Representation
Are you applying through an Agent or Educational Representative? Yes No
Agent’s/Educational Representative name:
Agent’s/Educational Representative address (including Country & post code):
Agent’s/Educational Representative email address:
Please tick the box to give consent for the agent to act on your behalf regarding your application for
admission to De Montfort University and to confirm that you understand and agree to the following
conditions:
The agent will be acting on my behalf and not on the behalf of DMU and thus unable to contract on behalf of, or bind, DMU.
The Agent will hold and process information solely for the purpose of my application to DMU and all communications will be
sent to my nominated Agent’s email address. Any notice to amend or cancel the Agent who is acting on my behalf must be
communicated by me in writing to both the Agent and DMU. A Change of Agent form must be completed and returned to the
International Admissions office if I choose to change Agent, and will be effective once received by DMU.
I agree
Will your study be funded in part or full by a sponsor? Yes No
Sponsor’s name:
Sponsor’s address (including Country & post code):
Sponsor’s email address:

If yes, please tick the box to give your consent for DMU to pass information
I agree
about your application and to your sponsor.
Please tick the box for DMU to pass information about your application on to
I agree
our foundation provider, should we need to offer an alternative study route
Please tick the box for DMU to contact the Home Office to conduct
I agree
immigration history checks
Section 8: Declaration
By submitting this form I declare that, to the best of my knowledge, the information I have provided is correct. If
enrolled, I agree to abide by the Regulations in force at the time.
Signed Date
Next steps
If you do not have all supporting documents available at the time of application, we will still be able to make you a conditional offer.
Please tick the boxes and attach the documents which you currently have available to support your
application:
Academic transcripts Yes No
Attach all your academic transcripts from your education since the age of 16.
Personal statement Yes No
Provide a statement, explaining why you wish to study this course, what skills and knowledge you have, your longer term
career aspirations, and any additional information to support your application.
Your references Yes No
One reference is required to support undergraduate study and two references for postgraduate study.
Work Experience Yes No
Provide details of all the jobs you have held (if any) since the age of 18. A CV is also acceptable.
Passport copy Yes No
Please attach a copy of your current passport. If you have studied in the UK previously, please attached all
previous Visas.
English Language Evidence Yes No
Portfolio Yes No
Please note some courses may also require you to submit a portfolio or audition.

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International Application Form

Please complete ALL sections of this form clearly AND ACCURATELY.

Section 1: Your course

Month and Year of Entry: How do you wish to study?

September January 20 Full-time Part-time* Distance

Section 2: Your personal details

Mr Mrs Miss Ms Dr Professor Other

Gender: Date of birth (DD/MM/YYYY):

Country of birth: Nationality:

Your personal email address:

Section 5: Academic history

Date started Date finished Examinations taken and

Date started Date finished Examinations taken and

Do you have an unspent conviction? Yes No

Agent’s/Educational Representative name:

Agent’s/Educational Representative address (including Country & post code):

Agent’s/Educational Representative email address:

Will your study be funded in part or full by a sponsor? Yes No

Sponsor’s address (including Country & post code):

Sponsor’s email address:

Academic transcripts Yes No

Personal statement Yes No

Your references Yes No

Work Experience Yes No

Passport copy Yes No

English Language Evidence Yes No

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