UK
Immigration History Form
This form is intended for students who will require a Student visa to study in the UK.
Before we can offer you a place at City, we first need to ensure you are eligible for Student
visa sponsorship. We need this information to check your proposed course of study against:
1. UKVI rules on study time limits (for UG students only)
2. UKVI rules on academic progression
When completing the form, please ensure that you include all study periods in the UK, including English language
and short courses as well as courses not completed. When returning this form, please send us a scan of all your
visa(s) and passport.
Personal details:
Muidh Saleh J Alqahtani
First name: ______________________________ Family name: __________________________________
07/03/1992 Saudi Arabia
Date of birth (dd/mm/yyyy): ________________ Nationality: ____________________________________
Applicant no: 210034079
City, University of London Student Number: ____________ Passport Number: _ _______________
If successful in receiving an offer to study at City, will you be applying for Student visa inside or outside of the UK?
☐ Inside the UK
☐ Outside the UK
Have you ever been refused a UK visa?
☐ NO
☐ YES
If YES, when were you refused a UK visa(s)?
What were the grounds for refusal? (You should also send a copy of the refusal notice with your completed form)
UK Academic History:
Name of the Course Title Level of Study: Did you Visa type Visa start Visa expiry
UK (e.g. GCSE, A levels, Common European successfully (e.g. Tier 4 date date
Educational English course, Framework of complete General, Tier 4 (dd/mm/yyyy) (dd/mm/yyyy)
Foundation, Reference (CEFR) Child, Student
Institution Bachelor’s, Study for language this course? visa pre‐March
Abroad, Pre‐ courses (A1, A2…) 2009, Student
Master’s, ACCA, Level 3 – A Visitor, Short
Master’s, Levels/Foundation Yes / No / In Term Student, C
Postgraduate Programmes ‐ visit ‐ student;
progress
Certificate/Diploma, Level 6 – If your visa was
PhD, etc.) Bachelor’s Degrees not for study,
Level 7 – Master’s please state the
degree/PGC type)
Level 8 ‐ PhD
New College General English English Course Yes C - Short term
22/05/2019 22/11/2019
Group Course student
Please list details of any other period(s) of time you have spent in the UK not listed above:
Visa start date Visa expiry date
Visa type Purpose of stay in the UK (dd/mm/yyyy) (dd/mm/yyyy)
Comments: Is there anything else you need to tell us? No
Declaration:
I confirm that, to the best of my knowledge, I have provided complete and accurate information and that I have
declared anything that could affect my immigration application or status in the UK.
Signed: ___________________
Date: ____________________
UKVI Consent Form
As a Student Visa Sponsor we are able to check directly with the UK Visas and Immigration (UKVI),
who will provide us with information about your immigration status.
UKVI recognise that there are some instances when we, the sponsor, and you may not have
information about your current immigration status, and therefore the UKVI would be happy to
clarify the situation.
To do this we require your written permission to contact the UKVI directly.
Please complete, sign and date below so that we have your written permission and consent to
check with UKVI directly.
Muidh Saleh J Alqahtani
Full name: ______________________________
07 March 1992
Date of birth: ____________________________
Saudi Arabia
Nationality: _____________________________
Passport Number: ________________________
Date: __________________________________
Sign: ___________________________________
If you cannot provide proof of entitlement to stay in the UK, you will not be permitted to start or
return to your course until you can present the appropriate immigration documents that grant
you permission to stay and study in the UK.
Visa Compliance Team
City, University of London
Northampton Square
London, EC1V 0HB
United Kingdom
E: visacompliance@city.ac.uk
