INTERNATIONAL STUDENT APPLICATION FORM 2012/13

FOR OFFICE USE ONLY

Course: ……………………………………………………………….
Decision: Unconditional
Conditional Offer
Reject

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Admissions Tutor: .……………………………………………………

Please state condition……………………………………………………………………………………….
Please state reason………………………………………………………………………………………….

(The International Office will ensure that financial and English language entry conditions are satisfied)
Signature: …………………………………………………………...

Date: ………………………………………………………………………

1. Personal & Contact Details
Boxes marked with an asterisk * are required fields. If any boxes marked with an asterisk * are not completed the application will not be considered and will be returned to you
for completion.

First Name: *

Middle Name: *

Surname / Family Name: *

Date of Birth: *

Age: *

Sex: * (Please Circle)
Male

Female

Passport Number:

Country of Birth: *

Nationality: *

Email Address: *

Mobile Phone:

Home Phone:

Home Address – Please use one box per letter, please include spaces in between words
Address Line 1
Address Line 2
Address Line 3
Town / City
State / Province
Country
Postcode / pin *
Correspondence Address – If different from the above address (e.g. agent address)
Address Line 1
Address Line 2
Address Line 3
Town / City
State / Province
Country
Postcode / pin *

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please include certified translation of your documents. Please attach copies of original certificates to this application. Your first preference will be processed first. Year 1) Course (e. second and third preferences will only be processed if your first choice application is unsuccessful. English Language Proficiency If English was the language of instruction in your secondary school.org/toefl for further information on how to obtain a recognised English language qualification.ets. Course Preference Please list your preferred course in descending order and include course code if known. Please visit www. No. IELTS 6. 2. Year of entry to Glyndŵr? (Please circle) * September 2012 February 2013 2/5 . If the original language is not English.g.org or www. Please quote Glyndŵr’s TOEFL number 8719 when sitting your TOEFL test. Please attach copies of original certificates to this application as proof. please provide further details: Name of Institution Level of Study (e. 3.0) 4. Name of Institution * Years attended (from – to) * Completed (Yes / No) * Name of qualification & grade obtained * Language of instruction * Completed (Yes / No) Name of qualification & grade obtained Language of instruction Completed (Yes / No) Name of qualification & grade obtained Language of instruction - Name of Institution Years attended (from – to) - Name of Institution Years attended (from – to) - 3. BEng Aeronautical & Mechanical Engineering) * 1.ielts. 3. Without copies of original certificates Glyndŵr University is unable to process your application. Education & Training Please list your academic qualifications. Without copies of original certificates Glyndwr University is unable to process your application: Type of Qualification (e. 2.g.2. Year of Entry * (e.g. your most recent should be at the top.g.g.g. higher secondary or University. IELTS) Test Date Test Score (e. secondary) Years attended (e. 3 years) 1.

. ………………………………………………………………………………………………………………………………………………………………… …… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………. Employment Details Should you have any past or present employment position which may be of relevance to the program which you are applying for. why you want to study with us and what your career and life plans are after graduation... …………………………………………………………………………………………………. …………………………………………………………………………………………………. please attached to your application your CV along with a detailed description of your work experience..5. ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ……………………………………………………………………………. …………………………………………………………………………………………………... ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… …………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ……………………………………………………………………………. 6. Please complete on a separate sheet if necessary. ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………….. 3/5 . including written evidence from your employer. ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… …………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… …………………………………………………………………………….. Personal Statement Please tell Glyndŵr University something about yourself. It should include details about your previous studies. ………………………………………………………………………………………………….

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4 If no option is selected. For further details about the accommodation packages we offer please refer to the ‘International Student Accommodation Guide’ which is available online at www.Free Welcome Pack on Arrival (includes . Please select which tuition fee + accommodation package you would prefer. STANDARD ACCOMMODATION * SUPERIOR ACCOMMODATION * PREMIUM ACCOMMODATION * . 2) Superior accommodation from September 2012 to June 2013.Off-Campus .Free Welcome Pack on Arrival (includes .950 This option includes: 1) The cost of your tuition fees for the academic year. regardless of which fee package option they choose in year 1. Tuition Fee + Accommodation Packages Our fee packages include the cost of tuition for the 2012/13 academic year and the cost of accommodation for the 2012/13 academic year.400 MBA (1 year course): £9. 2) Standard accommodation from September 2012 to June 2013.glyndwr. pillow cover and bed sheet) pillow cover and bed sheet) pillow cover and bed sheet) * For further details about the accommodation packages we offer please refer to the ‘International Student Accommodation Guide’ which is available online at www.En suite Bathroom .400 MBA (1 year course): £10. a mattress cover.900 MBA (1 year course): £10. a mattress cover.950* PGT (1 year course): £10. duvet cover. UG: £8.Single or Shared Bathroom . duvet.Shared Kitchen facilities . duvet.Shared Kitchen facilities .uk.Free Welcome Pack on Arrival (includes a mattress cover.950* PGT (1 year course): £9.3 Although we endeavor to match your selection preference at all times this may not always be possible.On-Campus . the option by default will be Option 2 * All undergraduate students must pay £7.950 in each subsequent academic year of study to cover the cost of their tuition fees. * Please be aware that in subsequent years of study on undergraduate courses your tuition fees do not include the cost of accommodation. 2) Premium accommodation from September 2012 to June 2013. We will notify you in writing if we cannot match your selection preference.glyndwr.On-Campus (new accommodation) .Shared Kitchen facilities . 1) The cost of your tuition fees for the academic year.950 UG: £7.uk.ac. UG: £6. 8. 1) The cost of your tuition fees for the academic year.8.450* PGT (1 year course): £9.950* PGT (1 year course): £8.500 8. 5/5 . duvet cover.ac. duvet. 8.5 £500 discount may be offered as partner scholarship to students from our partner institutions.En suite Bathroom . 8.000 MBA (1 year course): £8.2 You may change your tuition fee + accommodation package selection up to the point of deposit payment. 8.1 Please choose your preferred fee package by ticking the relevant box: OPTION 1 OPTION 2 OPTION 3 OPTION 4 TUITION FEE + STANDARD ACCOMMODATION TUITION FEE + SUPERIOR ACCOMMODATION TUITION FEE + PREMIUM ACCOMMODATION TUITION FEE ONLY This option includes: This option includes: This option includes: 1) The cost of your tuition fees for the academic year. Once you have paid your deposit you cannot change your selection. duvet cover.450 UG: £8.

.. including all supporting documents. Mold Road.... Submit your completed application form............. to an official Glyndŵr University representative in your home country... to us at: International Office.ac......... Plas Coch.. Details of our representatives can be found at http://www...... If you fail to disclose a relevant conviction.. health related conditions or special educational needs? If yes please give brief details including medical evidence and any special provision you think may be required. Glyndŵr University....... Submitting your application to the University There are three ways in which you can submit this application form to us: 1.. including all supporting documents to: international@glyndwr. including all supporting documents....... 10.9.. ……………………………………………………………………………….. Wrexham... Post the completed application form....ac... United Kingdom.. Criminal Convictions Do you have any relevant criminal convictions? YES NO (If yes please provide further details) Relevant criminal convictions are those for offences against the person..…...... Additional Needs Do you have any disabilities. Declaration I certify that the details I have provided and any other supporting papers are true and accurate... understood and fully Glyndŵr University’s International Fee Regulations 2012/13 policy.................. I confirm that I have read.. How did you find out about Glyndŵr University? Family or Friend Education Exhibition School/College/University Glyndŵr Website Education UK Website Recruitment Agent Current Student Other 11... 6/5 ... or for offences involving supplying controlled drugs or substances where the conviction concerns commercial drug dealing or trafficking.. I understand that the information on this form is confidential. Date……………………………………………………………………........ Email a scanned copy of the application form.. 3.... but may be passed to official UK government bodies to assist them in their duties if requested. any offer that has been made to you will be withdrawn from the University.. whether of a violent or sexual nature.... Signed……………………………………………………………………. Wales.uk.glyndwr... You must also tick this box if you are currently serving a prison sentence for a relevant criminal conviction...... 7.....uk.. LL11 2AW....... 2..

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