Application Form

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Application Form
Please read the course details and the Terms and Conditions carefully before you complete this form.

PERSONAL DETAILS – details & spelling must be the same as shown in your passport Family name First name(s) Other names Sex (m/f) Date of birth* Nationality Country of birth Passport No Email address Telephone No qNo

*Will you be at least 18 years of age at the start of your course? qYes Permanent address Address line 1 Address line 2 Address line 3 Town/city Region Country Post code

Contact address (if different) Address line 1 Address line 2 Address line 3 Town/city Region Country Post code

Do you have any disability or special needs you wish to tell us about? qYes qNo If yes, give details (or enclose a separate sheet.) COURSE FEES
Who will pay your course fees? (please tick ü one box)

Were you introduced or helped by an agent?

q Myself q My sponsor Sponsor’s Name:

q Yes q No Agent’s name: Agent’s email:

Please send proof of sponsorship with your application Acceptable sponsors include universities, government agencies, charitable organisations and registered international companies

ENGLISH TEST SCORES - Please give details of your most recent English test: Type of test
(e.g. IELTS/TOEFL etc)

Test centre/school Test date Score
This is required for pre-sessional applicants. Please send a copy of your English test certificate with your application.

VISA REQUIREMENTS – please tick ü ONE box q I require a Confirmation of Acceptance for Studies (CAS) for a Tier 4 student visa.
Updated Sept 2011

q I have an unconditional offer to study at The University of Sheffield after the language course. I require a combined CAS for both courses. q I do not need a visa to study in UK (e.g. EU nationals). q I will apply for a dependant visa q I will apply for a Student Visitor Visa (maximum 6 months) q I will apply for an Extended Student Visitor Visa (maximum 11 months)
For information on visas please see

UNIVERSITY PLANS - If you will study at a British university after your English course, please give details: q University of Sheffield q Other: University Department Course Start date Applicant No. Offer status English level required q Unconditional q Conditional q Don’t know

COURSES - Please refer to the recommended Entry Levels on our website. Please indicate which course(s) you would like to take: University English Courses 2011-12 ü q q q Term Term 1: Term 2: Term 3:
(New starters must join Summer School – see below)

Dates 26 September 16 December 2011 16 January 30 March 2012 23 April 08 June 2012

Course q University English q Management English q University English q Management English q University English q Management English

Week s 12 11 7

Fees £2940 £2695 £1715

International Summer School (23 April – 31 August 2012) ü q q q q Pre-sessional 17 weeks 10 weeks 6 weeks 4 weeks Dates 23 April – 31 August 25 June - 31 August 23 July - 31 August 06 August - 31 August Course q Academic English q Academic English q Management English q Academic English q Management English q Academic English Fees £4165 £2450 £1470 £980

(2 weeks vacation 09/6 – 24/6/12)

STUDY English Start Dates PLUS Options Please indicate which weeks you wish to study (minimum 3 consecutive weeks):

Fees £245 per week

q q q q q q q q q q

25 02 09 16 23 30 06 13 20 27

June July July July July July August August August August

Declaration: I have read and understood the Terms and Conditions relating to this application, including the advice on insurance. Signature:__________________________________________________ Date: _____________________________ Please send this form, a copy of your passport photograph page and your English language certificate to: ELT Centre, The University of Sheffield, 78 Hoyle Street, Sheffield, S3 7LG, UK Telephone: +44 114 222 1780 Fax: +44 114 222 1788 e-mail: [email protected]
Updated Sept 2011

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