APPLICATION FORM GUIDANCE NOTES

The following guidance notes are designed to help you when filling in your application to the Language Centre. Please read the information carefully BEFORE you complete all sections of the application form. For more information on applying please see our website www.leeds.ac.uk/arts/info/20056/language_centre. If you have further questions about how to complete this application form please contact us at langc@leeds.ac.uk. Please note, completed application forms should be sent to elapplications@leeds.ac.uk with all the necessary supporting documentation. Applications cannot be processed without the supporting documentation. 1. Applicant details The details you enter in this section must match those on your passport exactly. This is very important. If you do not have a passport please tell us in the passport number section with the date you expect to receive it (if known). You will still need to fill out all other details in this section. If you do not know which type of visa you will be applying for, you can find guidance on the UKBAs website www.ukba.homeoffice.gov.uk/visas-immigration or the International Student Office website www.internationalstudentsupport.leeds.ac.uk 2. Contact details Your correspondence address should be the address where we can contact you. We will send all documentation to this address, for example, your offer letter and joining instructions. If this address is not your permanent home address (the address in your home country), please enter this second address in the space below. 3. Personal details Please complete all parts of this section. If you are currently studying at a university or working for a company, please write the name of the university or company here. 4. Programme details Please select the programme you wish to study and the term or terms by ticking the relevant box. For specific term dates please see the Language Centres Fees and Dates document which is available to download from our website. You can apply for more than one term but you can only take one course each term. We have provided recommended study periods depending on your current level of English and the level you wish to reach in the downloads section of our website. If you require advice about the most suitable course for you please contact us at langc@leeds.ac.uk During the summer you can study on the General English Programme for 3 10 weeks over any period of time between the beginning and end of the summer term. Please enter the start and end dates of the period you wish to study in the appropriate section. The start date must be a Monday and the end date must be a Friday. You can study full-time or part-time on the General English Programme and you must select how you wish to study on the application form. Part-time options are NOT available for any other courses. For more information about our courses and their content please visit our website. 5. Academic Progression details If you have studied in the UK before you must tell us in this section. This will not affect how we assess your application. Please tick the relevant boxes and/or write the name of any people that you are happy for us to discuss your application with in this section of the application form. You should then read the final declaration and sign it to confirm that you have understood and fully completed the application form, truthfully and accurately. 6. Who will pay your course fees? Please state who will pay your course fees. If it is not you please give the name of the person or organisation that will be responsible for paying these fees. If you are offered a place on a Language Centre programme you will not be able to change the details given in this section of the application form. Your application will become invalid if the fee payer named here changes without the prior consent of the Language Centre. 7. University accommodation Please complete this section. If you do not require university accommodation, please tick the box No. 8. Personal statement You must complete this section to tell us more about yourself. Please write at least 2 sentences in answer to each question. This is compulsory. 9. Terms and conditions of payment for self-financing students If you are a self-financing student, you must read and sign this section. 10. Where did you hear about the Language Centre Please complete this section so that we know how you found out about the courses at the Language Centre. 11. With this form you must send Please make sure you have enclosed/attached a copy of all the documents requested in this section that are relevant to you. We cannot process your application without these documents. This is very important. If you do not include the necessary documents there will be a delay when processing your application. 12. Criminal convictions If you have been convicted of a criminal offence, excluding a motoring offence for which a fine and/or a maximum of three penalty points were imposed 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 you will be required to disclose all criminal convictions. Please see information provided by the relevant School. If you would like more information about why we are asking for this information please contact us at langc@leeds.ac.uk. Please note that the information you provide will be handled in accordance with the terms of the Data Protection Act 1998. 13. Declaration Due to Data Protection law we cannot give out information about an application to any friend or family member unless consent has been given by the applicant. In some cases we may still be unable to provide information to a friend or family member.

The Language Centre

1. Applicant details (as shown on your passport): Passport number: 370034 Title: Family name: AMER Day Month Year Date of Birth:
8

Tick ()

Mr

Mrs

Ms

Miss

Dr

Other names: ABDELNASER.M.MOHAMED Nationality: Libyan Country of Birth: LIBYA Tier 4 Dependent N/A

11

1970

Which type of visa are you planning to study on? Student Visitor 2. Contact details Correspondence Address: City Benghazi Postcode/ZIP 00218918097094 Tel:

Garyounis st. 7000 building units 131 building Apt 8

State/Province/Region Benghazi Country LIBYA Fax: Email:

Home address (this is compulsory if different from above):

City Postcode/ZIP Tel: 3. Personal details First Language:

State/Province/Region Country Fax: Email:

Occupation:

lecturer

Do you suffer from any disability or health problems? (This information is confidential) Tick () Yes No s If yes, please give details:

What are you doing currently?

Work s

Study

Other

Name of company/institution/other

University of Benghazi

4. Programme details For specific term dates please see the Language Centres Fees and Dates document which is available on our website or contact us at langc@leeds.ac.uk Tick () Year of programme start 2012 2013

October - June
General English Programme English for everyday communication How do you wish to study ? (General English Programme only) Academic English for Undergraduate Studies pre-sessional preparation for undergraduate studies Academic English for Postgraduate Studies pre-sessional preparation for postgraduate studies Term 1a Term 1b full-time(all day) s Term 1 Term 2a Term 2b Term 3a Term 3b

part-time (mornings only) Term 2 Term 3

Term 1

Term 2

Term 3

Academic English for Business Programme A & Management pre-sessional preparation for postgraduate studies in Business & Management

Programme B

July - September
General English Programme English for everyday communication How do you wish to study ? (General English Programme only) Summer full-time(all day) Start Date part-time (mornings only) End Date

Academic English for Undergraduate Studies pre-sessional preparation for undergraduate studies Academic English for Postgraduate Studies pre-sessional preparation for postgraduate studies Academic English for Business & Management pre-sessional preparation for postgraduate studies in Business & Management

10 Week 10 Week 10 Week

6 Week 6 Week 6 Week

InterComm Pre-sessional Programme 6 Week preparation for postgraduate studies in communication studies, journalism, politics, development studies, translation and interpreting Special Postgraduate Entry Scheme preparation for postgraduate studies for Chinese students only 10 Week

Name of Language Centre programmes currently being studied or previously applied for Programme fee(s) do not include accommodation fees.

5. Academic Progression details Have you previously studied in the United Kingdom at any point? If yes, please answer the following questions: What dates did you study in the UK between? Start date End date Tick () Yes No

What level of study did you undertake (e.g. English language, A-level, undergraduate degree)? OR what qualification did you obtain?

Please provide the name of your previous institution:

What type of visa did you have during your studies?

Student Visitor

Tier 4

Dependent

Other

6. Who will pay your course fees? If you are accepted on to a Language Centre programme you will not be able to change the details given in this section of the application form. Your application will become invalid if the fee payer named here changes without the prior consent of The Language Centre. Tick () You s Other

Please give details:

I have scholarship from Ministry of Libyan Higher Education.

I accept responsibility for the payment of the course fee if my sponsor fails to make the payment.

7. University accommodation University accommodation is normally available for Language Centre students in single study bedrooms in selfcatering flats. Details and application forms for University accommodation will be sent with acceptance packs. Do you require information about University accommodation? Tick () Yes No

Please note that all accommodation costs must be paid directly to the University Accommodation Office NOT the Language Centre.

8. Personal statement Please answer the following questions in your own words. Write one or two sentences in answer to each question. Continue on a separate sheet if necessary. This section is compulsory. 1. Please describe your current job or studies. 2. Are you studying English now? Where? What is your level? 3. What will you do after your English course in the Language Centre? 4. Have you applied for a degree programme at the University of Leeds?

1. I am a lecturer in University of Benghazi. 2. No, I am not studying English now. 3. I will study PhD in accounting.
4. No, I have not.

If already accepted for an academic course, please attach a photocopy of your letter of acceptance from the university/institution at which you will study. If you have taken an IELTS, TOEFL or PEARSON test, please attach a copy of your most recent results certificate.

9. Terms and conditions of payment for self-financing students Payment of programme fees The fee payer (the person or institution responsible for paying your fees) must be the same as the fee payer named in Section 5 of this application form. After you have begun your programme you must pay the programme fee in full. During the first week of your programme you will receive an invoice requesting payment of your programme fee. The fee must be paid within 12 days of the start of the programme. If you leave your programme early, that is, at any time before the published end-of-programme date, you do not have the right to a refund of the programme fee. Payment should be made in person at University Cash Services (Level 9, Marjorie & Arnold Ziff Building) by cash, cheque, bankers draft, credit card or travellers cheques. Your invoice must be presented with your payment. Please note that change cannot be given for travellers cheques. If you wish to pay your fee by bank transfer, please see Applying for English language courses on our website. When arranging payment of your tuition fees do not include payment for accommodation or living expenses. I confirm that I have read and understood the Terms and conditions of payment for self-financing students shown above regarding programme fees for Language Centre programmes and hereby agree to the terms and conditions as stated. Signature: Date:

10. Where did you hear about the Language Centre? Tick () From an agent/representative From an advert From your government From the internet From a friend Other
s

Name of agent/representatives company: Where did you see the advert? Name of publication: Please state: Website address: Please state: Yes No

If the option was available, would you have applied online? 11. With this form you must send Tick () For all students: a clear copy of the passport pages showing your name, nationality and passport number one photocopy of your English language report or certificate one photocopy of your IELTS, TOEFL or PEARSON test results certificate For all students, if applicable: one photocopy of your letter of acceptance from the university/institution at which you will study a copy of your visa if you are already in the United Kingdom

For sponsored students ONLY: s written confirmation from your sponsor to cover payment of Language Centre programme fees if they are to be paid by a sponsor and not by you or your family For self-financing students: please also ensure you have read and understood the Terms and conditions of payment for self-financing students and signed the Declaration in Section 8 on this application form

Please send your application to: Admissions Secretary, The Language Centre, University of Leeds, Leeds, LS2 9JT, UK T: +44 (0) 113 343 3251 F: +44 (0) 113 343 3252 E: Completed applications: elapplications@leeds.ac.uk Enquiries: langc@leeds.ac.uk http://www.leeds.ac.uk/arts/info/20056/language_centre

12. Criminal Convictions Applicants are now legally required to declare at the point of application if they have been convicted of a criminal offence. Have you been convicted of a criminal offence? Tick () Yes No

If you are a serving prisoner, please supply the prison address in the box below.

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 answering the yes in this 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. 13. Declaration In accordance with the Data Protection Act 1998 we are required to ask for your consent for details about your academic progress and well-being to be released. If you do not give consent we are unable to answer any questions about you and your application to anyone other than yourself. This consent does not affect the University's ability to disclose your information to third parties where allowed under the University's Data Protection Code of Practice, to view a copy of this please visit http://www.leeds.ac.uk/secretariat/data_protection_code_of_practice.html. Please tick the appropriate box below if you agree that the Language Centre may, without the need to obtain your further consent, give information to the identified group. I give my consent for details about my studies to be released to my: (please tick, as appropriate) Home university Sponsor Agent Family / Friend (please include name) Name(s)

I confirm that I have read, understood and fully completed this application form, truthfully and accurately. The Language Centre cannot be held liable for information that is inaccurate, omitted, or withheld by the applicant. If the English language programme offered proves unsatisfactory or unsuitable due to information on this application form being inaccurate, omitted, or withheld, the Language Centre will not be held responsible and will not be obliged to offer an alternative programme. The Language Centre reserves the right to offer a suitable, alternative programme, to any applicant if (s)he fails to meet any of the course requirements before or during their period of study.

Signature:

Abdelnaser

Date:

07 / 01/ 2013