APPLICATION FOR TAUGHT POSTGRADUATE STUDY

(Before completing this application form please read the attached notes for guidance)
B PLANNED PROGRAMME OF STUDY
(FOR OFFICE USE ONLY) ADMISSION DECISION
Qualification and Programme Title
Conditions
D/L F/T P/T
(Please return this form as soon as possible to: Taught Postgraduate Admissions, 17 Blenheim Terrace, University of Leeds,
Leeds, United Kingdom LS2 9JT together with original copies of any supporting documentation).
Proposed date of entry
Miss/Ms/Mrs/Mr/Dr
Family Name (as stated on your passport):
Given Names (as stated on your passport):
Passport Number
Previous Name(s), if changed:
Applicant Permanent Home Address (mandatory)
Tel. No.
Email:
Tel. No.
Date of Birth:
Nationality: Country of Birth:
(See notes for guidance) (See notes for guidance)
Residential Code Disability Code
Please turn over
Accept Reject
Date(s) From: To:
If you have attended or are presently attending the University of
Leeds, please enter your Student ID number here:
Male
Month Year
Day Month Year
Email:
Faculty / School / etc.
Title
Gender
Qualification Title
e.g. (MA/MSc)
Female
Distance
Learning
Full
Time
Part
Time
D/L F/T P/T Major Course Code
Signature and Date
Banner Programme Code
Conditions
Accept Starting Date Progression Code Period of Study (enter number in box) Reject
Conditions
Day Month Year
academic year(s)
semesters
months
Admissions Tutor or Nominee
(Please return this form as soon as possible to: Taught Postgraduate Admissions, 17 Blenheim Terrace, University of Leeds,
Leeds, United Kingdom LS2 9JT together with original copies of any supporting documentation)
Qualification and Programme Title
Day Month Year
Expiry Date
Correspondence/Agent Address (if different)
A PERSONAL DETAILS (please complete using BLOCK CAPITALS throughout)
C CURRENT OR PREVIOUS EDUCATION (most recent first)
D UK VISA/RESIDENCE PERMIT HELD (if applicable)
E ENGLISH LANGUAGE QUALIFICATIONS
F OTHER COURSES AND EXPERIENCE
Details of any other courses taken or other qualifications that are relevant to this application:
Details of relevant practical experience:
Date of Course
Qualifications (please tick)
Title of Course
Qualifications obtained or to be taken
(give dates and grades).
Institution
Finish Start
Subject(s) Dates
Other English Language qualifications: e.g. GCE/GCSE, Cambridge Proficiency, Cambridge Advanced English, please specify:
Grade
Start Expiry
IELTS
IELTS - TRF number
TOEFL - Internet-based
TOEFL Registration number
Pearson - PTE Academic
Grade Date
Qualification
Visa/Permit type
Test Date
DD/MM/YY
2
Overall Score Listening Reading Speaking Writing
Name and Address of Employer Job-title
From
MM/YY
H REFEREES
You should enclose two academic references with your application. References must be requested by the applicant.
I HOW DID YOU LEARN ABOUT THE UNIVERSITY OF LEEDS?
G EMPLOYMENT HISTORY (most recent first)
How did you first learn about postgraduate study opportunities offered at the University of Leeds?
Have you applied to the University before? Yes? No?
If yes, to which School/Faculty?
If yes, which year did you apply?
To which other institutions have you applied?
J ADDITIONAL INFORMATION (See notes for guidance)
Name
Occupation
Address
Tel No.
Fax:
Email:
Name
Occupation
Address
Tel No.
Fax:
Email:
Dates
To
MM/YY
3
If you have arranged sponsorship, give the name and address of your sponsor below and enclose a copy of your letter of confirmation
of funding. If no award has been made give details of the sponsors you are approaching.
Academic fees: sponsors which have made an award/been approached. *
Living expenses: sponsors which have made an award/been approached. *
Any criminal conviction? (See notes for guidance). If a serving prisoner, please supply the prison address in the box below.
No
Signature
Please send your completed application form with references, transcripts, English certificates (if applicable) and any letters of sponsorship
to: Taught Postgraduate Admissions, 17 Blenheim Terrace, University of Leeds, Leeds, United Kingdom, LS2 9JT
CHECKLIST (Please tick the box(es) to show which documents you have enclosed).
OFFICE USE ONLY:
Letters of Sponsorship
Two References
Academic Transcripts
Copy of Passport/Residence Permit
Application arrived in Taught Postgraduate Admissions on:
Application arrived in Taught Postgraduate Admissions Office
for recommendation verification on:
Application left Taught Postgraduate Admissions on:
Application arrived in School/Faculty on:
English Language Certificates
K FINANCE
Who will be paying your fees and providing funds for living expenses? (Please tick appropriate boxes).
Self: You will be required to satisfy the University that you have sufficient funds.
Sponsor: Have you already secured sponsorship for your studies?
Yes No
(* delete as appropriate)
Please note:
If you are not able to enclose transcripts and
ref erences with your application form, please
send them directly to the School offering
the course. (e.g. Taught Postgraduate
Admissions, Name of School, University
of Leeds, Leeds, UK, LS2 9JT).
Disclaimer: Where circumstances change outside the reasonable control of the University, the University reserves the right to change or cancel parts
of, or entire, programmes of study or service at any time without liability, even after students have registered at the University. Circumstances outside of
the Universitys reasonable control include, industrial action, over or under demand from students, staff illness, lack of funding, severe weather, fire, civil
disorder, political unrest, government restrictions and concern with regard to the transmission of serious illness.
Declaration: I confirm that the information I have provided is true and accurate. Any information found later to be false or inaccurate may lead to the
University withdrawing my offer or leading to my removal from a programme of study.
Privacy: You agree to the University processing your information in accordance with the Privacy Statement contained within the attached guidance notes.
Cancellation: If you receive an offer of a place on a programme you will be advised of your rights to cancel/withdraw your application.
Day Month Year
Date of Completion
Yes
Academic Certificates
4
Equal Opportunities Monitoring Form
Black or Black British
Caribbean 21
African 22
Other Black background 29
Mixed
White and Black Caribbean 41
White and Black African 42
White and Asian 43
Other mixed background 49
Other ethnic background 80
White 10
Gypsy or Traveller 15
Arab 50
Chinese
34
Asian or Asian British
Indian 31
Pakistani 32
Bangladeshi 33
Other Asian background 39
The following information is for Central Administration purposes and will not form part of the
academic decision-making process on your application.
Please complete the form below and place in a sealed envelope marked E.O. Monitoring Form.
Ethnicity details
For Central Administration use:
Family Name (as stated on your passport)
Given Name (as stated on your passport)
DD
Date of Birth
MM YY
If you have any queries regarding this form please contact the Equality Policy Unit at [email protected]
NOTES FOR GUIDANCE:
APPLICATION FOR TAUGHT POSTGRADUATE STUDY.
GENERAL
Please complete this form in black ink using block capitals throughout. Complete all sections of the application as fully as possible. If the section does not
apply to you please indicate this with N/A. Do not refer to attachments e.g. CV or resum. Provided that you complete all sections of the form, you may
supply additional detail on A4 paper.
A. PERSONAL DETAILS
Please include your Family Name (Surname) and Given Names (First names) as they are written in your passport or birth certificate. Do not use informal
or nicknames on your application.
Please include all previous names, e.g. name before marriage, so we can confirm that documents using a previous name refer to you.
If you are non-UK/EEA national you will need to provide us with the passport information stated. This information is required by UK law. If you do not
have a passport at the time of applying we will contact you during the application process requesting these details. Please note that you will not be able
to apply for a visa to enter the UK until after we receive this information.
DISABILITY CODE
If you have a disability, medical or mental health condition that may require additional support whilst at university, please select the following code that is
most appropriate to you. You may, if you wish, give further detail in section J of the application form.
00 No disability; 08 Multiple disabilities; 51 Specific Learning Disability e.g. Dyslexia/Dyspraxia; 53 Autistic Disorder; 54 Long Standing Illness; 55 Mental
Health Difficulties; 56 Wheelchair User/ Mobility Issues; 57 Deaf/ Hearing Impediment; 58 Blind/ Partially sighted; 96 Other.
RESIDENTIAL CODE
The University is required to make a decision about your fee status. To help us do this, please choose a category from the list below. The code you choose
is provisional. The University will make the final decision using Department for Business Innovation and Skills (BIS) and UKCISA (Council for International
Student Affairs) guidelines. If there is any doubt regarding your fee status, the University will ask you to complete a fee assessment form.
Please choose from the following categories:
A UK Citizen/EU
1
National: you are a UK or are the child of a UK or EU
1
national, and have lived in the European Economic Area (EEA
2
) or Switzerland
(or both) for three years, but not just for full-time education. If you are a UK national, you may also have lived in the Channel Islands or the Isle of Man (or
both) during these three years.
B Settled in the UK: you have Indefinite Leave to Enter or Remain in the UK or have the Right of Abode in the UK and have lived in the UK, the Channel
Islands or the Isle of Man (or more than one of these) for three years, but not just for full-time education. (However, this does not apply if you are exempt
from immigration control, for example, as a diplomat or a member of visiting armed forces or an employee of an international organisation or the family or
staff members of such a person. If this is your situation, your residential category is O). Please include a copy of your residence permit.
C Refugee status
3
: you are a refugee, or have been granted Exceptional Leave to Enter or Remain, Humanitarian Protection or Discretionary Leave in the
UK following an application for asylum, and you have lived in the UK, the Channel Islands or the Isle of Man since that status was recognised or granted,
or you are such a persons husband, wife or child.
D EEA
2
(non-UK/EU
1
) Living in UK: you are an EEA
2
or Swiss national, you live in the UK and you are a migrant worker (or you are such a persons
husband, wife or child), and you have lived in the EEA
2
or Switzerland (or both) for three years, but not just for full-time education.
G UK/EU
1
National Living Outside EEA
2
: you would otherwise meet the criteria of categories A, B, C or D, but you have been living outside the UK,
Channel Islands, Isle of Man, EEA
2
or Switzerland (or more than one of these) because you, your husband or wife, or your parent, have been
temporarily working outside the area in question.
O Other.
Note
1 The European Union (EU) includes the following 28 countries. Austria, Belgium, Bulgaria, Croatia, Republic of Cyprus, Czech Republic, Denmark (not
including the Faroe Islands and Greenland), Estonia, Finland, France (including the French overseas departments of Guadeloupe, Martinique, French
Guyana, Reunion, Saint-Pierre et Miquelon), Germany (including Heligoland), Greece, Hungary, the Republic of Ireland, Italy, Latvia, Lithuania,
Luxembourg, Malta, the Netherlands, Poland, Portugal (including the Azores and Madeira but not Macau), Romania, Slovak Republic, Slovenia, Spain
(including Ceuta, Melilla, the Balearic Islands and the Canaries), Sweden and the United Kingdom (with Gibraltar).
2 The European Economic Area (EEA) consists of EU countries plus Iceland, Liechtenstein and Norway. For the purposes of residence, this includes the
whole of the island of Cyprus.
3 The Home Office will have sent you a letter confirming your status if you are officially recognised as a refugee or if you have been granted Exceptional
Leave to Enter or Remain, Humanitarian Protection or Discretionary Leave in the UK. Please include a copy of this letter and your residence permit.
B. PLANNED PROGRAMME OF STUDY
Please read the current Postgraduate Prospectus carefully before completing this section. You should also contact the School you wish to apply to (using
the contact details in the Prospectus) for more detailed information about the programme of study. Some Schools require more specialised information in
order to process your application. You should ask if additional information is required or if there are any additional forms you must complete. Further details
may be accessed on the website: http://www.leeds.ac.uk/postgraduate
Part-time Study - Please check that the programme is offered on a part-time basis. Overseas applicants from non - EEA countries should note that, as
terms of entry into the UK will normally prevent you from seeking employment, it will not normally be possible for you to register for a programme on a part-
time basis.
C. CURRENT OR PREVIOUS EDUCATION
Please include details of your undergraduate degree and/or any other higher education qualifications that you feel are relevant to your application.
Please include transcripts of (or copies of) your results (including an explanation of the marking system) with your application. If these are in a language
other than English, please include official translations.
Please quote the title used on the degree certificate/transcript and indicate the system used i.e. grades, grade point average, percentage. If your final
result is not known at time of application, please indicate when your results will be known and send these to the faculty/school as soon as they become
available.
If you are a non EEA national, please list EVERY course you have studied within the UK.
In order to complete registration as a student of the University you will need to send us original or certified true copies of academic documentation
(Degree certificate, Degree Transcripts where applicable) so that we may verify previous qualifications. This can be done as soon as you receive your
offer letter from us or at any time during the admissions process. Alternatively, you can bring your original or certified true copies of documents with you
to be verified during the registration period.
D. UK VISAS/RESIDENCE PERMIT HELD (IF APPLICABLE)
Please include details of any UK visas or residence permits which you have previously held or currently hold (apart from tourist visas). Please include
details about any visa/ residence permit application you have already submitted.
E ENGLISH LANGUAGE PROFICIENCY
If you are unsure whether you need to provide evidence of English proficiency, please contact the School which you are applying to.
Please tick the box next to the qualification you have and fill in the details.
Please include copies of your results of any formal tests you have completed with your application e.g. IELTS, TOEFL.
If you are not able to enclose proof of English proficiency with your application form, please send them directly to the School offering the course at a
later date.
F. OTHER COURSES AND EXPERIENCE
Please only include courses and information directly relevant to your application.
G. EMPLOYMENT HISTORY
Please include details of your previous and current employment.
H. REFEREES
Full, clear and accurate contact details of two referees should be given to the University at the point of application; although it should be noted that it is the
applicants responsibility to ensure references are sent to the University. Academic Schools may request references from academic referees as a crucial
element of the selection process.
References should be from people not related to you by blood or marriage.
Your referees should be qualified to comment on your academic ability.
Important Information for Referees
References should be submitted on official headed paper and should be signed.
Please include the name of the applicant and the programme applied for.
Please also include your name, position/status, address, telephone number, fax and / or email address. The completed reference should
be placed in a sealed envelope which has been signed across the seal with a college or official stamp.
For a downloadable form please see http://www.leeds.ac.uk/downloads/referees.pdf
J. ADDITIONAL INFORMATION
Please indicate any additional support you may require as a result of a disability, medical or mental health condition. You may, if you wish, contact
Disabled Students Assessment or Support to ask for advice or information on 0113 343 3927 or email [email protected]
K. FINANCE
If you are being sponsored by your parent(s), please tick Self as this does not count as a sponsor.
UK or EU applicants who wish to be considered for a Research Council or other Government financed studentship for which application is made by the
School accepting the student (e.g. EPSRC quota scholarship) should indicate this clearly in this section.
Information on fees to be paid are available at http://www.leeds.ac.uk/pgtfees
Scholarships:
If you are applying for University or Faculty scholarships or bursaries you must apply on the appropriate form in addition to this application. The results of
scholarship applications are notified separately from the application for a place on a programme. All requests for information regarding scholarships should
be directed to: Research Degrees & Scholarships Office, University of Leeds, UK, LS2 9JT. Tel. +44 (0)113 343 4007.
Email: [email protected] Web page: http://scholarships.leeds.ac.uk
OTHER INFORMATION
CRIMINAL CONVICTIONS
If you have been convicted of a criminal offence, excluding a) a motoring offence for which a fine and/or a maximum of three penalty points were
imposed or b) spent sentences, you are required to declare this by completing the yes box in the criminal conviction section of the application
form. Serving prisoners should also supply the prison address so that a reference may be sought. The University will send a questionnaire for
completion to all successful applicants declaring a criminal conviction.The information submitted in the questionnaire will be treated in strict
confidence. For certain programmes of study e.g. in Medicine, Dentistry or the School of Healthcare you will be required to disclose all criminal
convictions. Please see information provided by the relevant School.
PRIVACY STATEMENT
This statement tells you how the University of Leeds as the data controller will collect and process your personal data when applying to it for a programme
of study. The information you have provided will be used by the University to process your application and to advise you of other University activities that
the University feels may be of interest to you as a prospective student, or for any other legitimate reason. Your information may also be processed by the
University for purposes of statistical analysis and passed on to other government or other agencies requiring such statistics. If you are an international
applicant your information may be shared with University approved representatives abroad who may contact you further. If you proceed to registration at
the University your information will continue to be used in accordance with the Universitys Code of Practice on Data Protection at http://www.leeds.ac.uk/
secretariat/data_protection_code_of_practice.html
Contact Information
If you have any queries relating to the privacy statement then please contact the Taught Postgraduate Admissions Office, University of Leeds, LS2 9JT
Tel: +44 (0)113 343 4044 Email: [email protected]
ADMISSIONS POLICY
For further information concerning applying to the University of Leeds for a taught postgraduate programme please see the following:
http://www.leeds.ac.uk/downloads/20022/postgraduate_taught
ACADEMIC TECHNOLOGY APPROVAL SCHEME (ATAS)
If you require a Tier 4 student visa to study in the UK and your course has a JACS code starting with an F2, F3, H3, H4, H8 or J5, you will need to apply
for Academic Technology Approval Scheme (ATAS) clearance. You need to have received your ATAS clearance certifcate before you apply for your Tier
4 student visa. To apply for ATAS clearance you will be required to provide the JACS code for your course and a list of optional modules that you plan to
study, which can be found at www.leeds.ac.uk/students/tpprogs
To apply for ATAS clearance visit www.gov.uk/academic-technology-approval-scheme