Enquires

Personal Information

Title: *

Fist Name:*

Surname/Family Name*

Gender: *

Male

Female

Date of Birth*

Home Address*

Correspondence address

Telephone No (inc dialling code)*

Mobile No.

Email*

Course Details

Mode of Study:*

Full-time

Part-time

Course Intake:*

January

February

March

April

May

June

July

August

September

October

November

December

What Course you want to apply ?*

Course Title:*

Course Title (if you want to apply more than one course):

Which Level you want to apply?*

Short-Course

Foundation

A-Level

Degree

Master

Doctor

Which University you want to apply?*

If the University name is not in the list please state the University you want to apply, or you want to apply more then one University:

Next of Kin

Name:

Relationship:

Contact No.:

Address:

Email:

For Agent / Representative Use Only

If you are agent or United Education Representative please give your information below:

Please Select:

Company name (If you are Agent):

Full name if you are United Education Representative

Student Immigration Details

I'm in:*

Overseas

If you are in UK, What Visa you are holding

First date entry UK

What Course you current Study:

Level of Course

Current University / College:

Course Completion Date:

Visa Expiry Date:

Academic Qualifications Details

Please give Name and address of the two most recent educational establishments attended.

Name of University / College*

University / College Address*

Title of Course*

Date of Start:*

Date of award*

Full - time

Part - time

Name of University / College*

University / College Address*

Title of Course*

Date of Start:*

Date of award*

Full - time

Part - time

English Language Qualification:

Do you have an English Language qualification ? eg GCSE English Language Grades A - C or equivalent, IELTS or equivalent:

Yes

Name of test

if yes, please give result here:

Work Experience:

Give details of work experience, training and employment.

Employer Name:

Address:

Form:

To:

Full-time

Part-time

Role and Brief Description of Responsibilities:

Continue on a separate sheet, or list in your CV if necessary and send by upload section.

Statement of Purpose:

Please give reasons for choosing the course and university or additional information that may be relevant to your application.

Name and address of referee(s) (Please give 2 of your referee one must academic referee.

Name*

Position/relationship*

Email:*

Contact No.:*

Address

Name*

Position/relationship*

Email:*

Contact No.:*

Document Upload:

(Please upload your document by PDF format only, this will help us to process your application, if you hold by other format, please convert before you submit to us, the Max size of upload will 3MB.

Your Passport and Visa:

Current CV:

Academic Qulification

Statement of purpose (700-1000 words):

Passport size photograph

Academic reference:

Work Experience Letter:

Copy of English Proficiency Certificate, approved by UKBA (e.g IELTS..)

Declaration

I can confirm that, to the best of my knowledge, the information given in this form is correct and complete. I have read the instructions, in particular those relating to this section. I understand what they say, and I agree to abide by the conditions set out there, which I accept as conditions of this application.

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