��ࡱ� > �� � � ���� � � � � �������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������������� e� �� >, bjbj{�{� j� �n\�n\$ # �� �� �� � � � n( n( n( n( n( ���� �( �( �( 8 �( �) \ �( �G T 2, f �- �- �- �- c/ L �/ �/ fG hG hG hG hG hG hG $ ;J � �L V �G n( $2 A/ " c/ $2 $2 �G n( n( �- �- � �G .5 .5 .5 $2 F n( �- n( �- fG .5 $2 fG .5 .5 � PC | �D �- ���� ��� ���� j2 F �C RG �G 0 �G �C � GM �2 B GM $ �D �D J GM n( �D d �/ Z 50 @ .5 u0 4 �0 { �/ �/ �/ �G �G �3 < �/ �/ �/ �G $2 $2 $2 $2 ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� ���� GM �/ �/ �/ �/ �/ �/ �/ �/ �/ � > 4' : Postgraduate Application Form for International Students (Taught and Research) Please complete all sections. If a section is not applicable, write N/A. Please return the completed form and relevant documents to the: International Admissions University of Lincoln Brayford Pool Telephone +44 (0)1522 886677 Lincoln Email HYPERLINK "mailto:intadmissions@lincoln.ac.uk" intadmissions@lincoln.ac.uk LN6 7TS Internet www.lincoln.ac.uk United Kingdom Privacy Statement The University of Lincoln will obtain and process personal data in order to perform and manage its operations, provide services and fulfil specific legal requirements. For further information, please read the University�s Privacy Statement: HYPERLINK "https://www.lincoln.ac.uk/home/abouttheuniversity/governance/universitypolicies/websiteandpublicationsinformationliability/" https://www.lincoln.ac.uk/home/abouttheuniversity/governance/universitypolicies/websiteandpublicationsinformationliability/ Agent Name: (Agent use only) Country of the branch * *Mandatory field to be completed Personal Details Title (Mr, Mrs, Ms, Miss etc) Full Name First/Given Names Surname/Family Name Preferred First Name/Given Name Previous Surname/Family Name (if changed) Gender Please select as appropriate ( Male ( Female Date of Birth (DD/MM/YYYY) Permanent/Home Address Address Post Code (if UK) Country Correspondence Address (If different, eg: agent / representative�s address) Address Post Code (if UK) Country Student Email Address Agent Email Address (If applicable) Contact Number (Student only) (Please remember your country code) Mobile Number (Student only) (Please remember your country code) Agent Telephone Number (If applicable) Course you wish to apply for Course Title Start Month and Year Language Qualifications Language Qualifications e.g. IELTS, PTE, GCSE Results, Grades, Marks Date Obtained Academic Qualifications Please give details of all your academic qualifications. Continue on a separate sheet if necessary. Qualification SubjectDate Obtained (Month and Year)Institution and Place of StudyGrade achieved Career History Please give details of work experience, training and employment. Continue on a separate sheet if necessary. Job Title EmployerFull Time Part TimeBrief Description of ResponsibilitiesFrom Month YearTo Month Year Supplementary Information Country of Birth Nationality Country of Permanent Residence (if different from your country of birth) Have you resided in the country of permanent residence as stated above for the past three years or more? ( Yes ( NoIf �Yes�, for what purpose? Please select as appropriate ( Study ( Work ( Family ( Place of Birth ( Other (please state)____________ Do you require a visa to study in the UK? ( Yes ( No If "Yes", have you previously studied in the UK? ( Yes ( No If �Yes�, please give details: Please attach a copy of your visa(s) to your completed application form Please continue on a separate sheet if necessary.Dates on visaCourse studiedInstitutionDid you successfully complete this course (Y/N)Valid fromValid until Have you ever had a visa application refused? ( Yes ( NoIf "Yes" please enter the date of refusal and the reason your application was refused. Please also attach a copy of your visa refusal document to your completed application form. Personal Statement Personal Statement Please summarise your academic interests and reasons for choosing your proposed course of study in the UK. We recommend that that you write between 200 and 400 words. If you are applying for a research degree, please attach your research proposal to this application. Do you have an impairment, health condition or learning difference? Please select as appropriate Please tick which of the following apply: FORMCHECKBOX 00 No known disability -------------------------------------------------- FORMCHECKBOX 08 Two or more impairments and/or disabling medical conditions FORMCHECKBOX 51 A specific learning difficulty such as dyslexia, dyspraxia or AD(H)D FORMCHECKBOX 53 A social/communication impairment such as Asperger's syndrome/other autistic spectrum disorder FORMCHECKBOX 54 A long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy FORMCHECKBOX 55 A mental health condition, such as depression, schizophrenia or anxiety disorder FORMCHECKBOX 56 A physical impairment or mobility issues, such as difficulty using arms or using a wheelchair or crutches FORMCHECKBOX 57 Deaf or a serious hearing impairment FORMCHECKBOX 58 Blind or a serious visual impairment uncorrected by glasses FORMCHECKBOX 96 A disability, impairment or medical condition that is not listed above The University of Lincoln Student Wellbeing Centre will contact you by email to discuss your disability, specific Learning difference, mental health or medical condition and can provide more information about their services and set up some support for when you enrol. Criminal Conviction Declaration For further information, please see the University�s Admissions Policy: HYPERLINK "https://secretariat.sites.lincoln.ac.uk/academic-policies-2/" https://secretariat.sites.lincoln.ac.uk/academic-policies-2/ IMPORTANT: Only complete this section if it is a requirement of the course you are applying to. Please visit the website course pages to check if you are required to answer this question: HYPERLINK "http://lincoln.ac.uk/home/studywithus/" http://lincoln.ac.uk/home/studywithus/ As part of the application process, applicants to programmes which lead to certain professions or occupations exempt from the Rehabilitation of Offenders Act 1974, are asked to declare if they have any spent or unspent criminal convictions. Enter X in the box if you have any spent or unspent convictions or other punishments that would appear on a criminal records check. FORMCHECKBOX If you enter X in the box you will not be automatically excluded from the application process but the University will request further information and consider each case on an individual basis. Please state how your tuition fees will be funded Please select as appropriate FORMCHECKBOX Self Funded FORMCHECKBOX Sponsor FORMCHECKBOX Other (please state)____________ 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. Name of First Referee Address Address Post Code (If UK) Country Email Telephone Number Name of Second Referee Address Address Post Code (If UK) Country Email Telephone 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: � FORMCHECKBOX Copy of highest qualification certificate, plus official translation if applicable; FORMCHECKBOX Copy of highest qualification transcript, plus official translation if applicable; FORMCHECKBOX Copy of English Language qualification(s) if English is not first language; FORMCHECKBOX Copy of research proposal (if applying for a research degree) FORMCHECKBOX If you will require a visa to enter or remain in the UK, please include a copy of your passport and a copy of any previous UK visa(s) or visa refusal documents; Should you require further details on the items to include, please contact the International Admissions Team for additional guidance via telephone +44(0)1522 886677 or email HYPERLINK "mailto:intadmissions@lincoln.ac.uk" intadmissions@lincoln.ac.uk Declaration I confirm that, to the best of my knowledge, the information given in this form is correct and complete. I understand that in accepting an offer, I agree to abide by the University of Lincoln Terms and Conditions and University Regulations and Policies published on the University�s website. 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