You are on page 1of 6

INTERNATIONAL STUDENT APPLICATION FORM 2012/13

FOR OFFICE USE ONLY

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

¨
¨
¨

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 *

1/5

Please attach copies of original certificates to this application.g.ielts.2.g. Please quote Glyndŵr’s TOEFL number 8719 when sitting your TOEFL test. 3. Year of entry to Glyndŵr? (Please circle) * September 2012 February 2013 2/5 . 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.g. your most recent should be at the top. Without copies of original certificates Glyndŵr University is unable to process your application. please include certified translation of your documents. Please attach copies of original certificates to this application as proof. 2.0) 4. please provide further details: Name of Institution Level of Study (e. Education & Training Please list your academic qualifications. No. higher secondary or University. Please visit www. 2. Course Preference Please list your preferred course in descending order and include course code if known. second and third preferences will only be processed if your first choice application is unsuccessful. 3. English Language Proficiency If English was the language of instruction in your secondary school.g.org/toefl for further information on how to obtain a recognised English language qualification.g.g. BEng Aeronautical & Mechanical Engineering) * 1. IELTS) Test Date Test Score (e. Year 1) Course (e. Your first preference will be processed first.org or www.ets. Without copies of original certificates Glyndwr University is unable to process your application: Type of Qualification (e. secondary) Years attended (e. 3 years) 1. If the original language is not English. IELTS 6. Year of Entry * (e.

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

. ………………………………………………………………………………………………………………………………………………………………… …… 4/5 .. ………………………………………………………………………………………………………………………………………………………………… …… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………………………………………………… ………………………………………………………………………. ………………………………………………………………………………………………….………………………………………………………………………………………………….

duvet. 8.950* PGT (1 year course): £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. duvet cover. 8.950* PGT (1 year course): £10.Free Welcome Pack on Arrival (includes . 8.On-Campus (new accommodation) .Free Welcome Pack on Arrival (includes a mattress cover. * Please be aware that in subsequent years of study on undergraduate courses your tuition fees do not include the cost of accommodation. regardless of which fee package option they choose in year 1. 2) Superior accommodation from September 2012 to June 2013.000 MBA (1 year course): £8.450* PGT (1 year course): £9.4 If no option is selected.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. UG: £6.ac.Shared Kitchen facilities .900 MBA (1 year course): £10.Shared Kitchen facilities . We will notify you in writing if we cannot match your selection preference. 2) Premium accommodation from September 2012 to June 2013.Shared Kitchen facilities .ac.950 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.950* PGT (1 year course): £9.2 You may change your tuition fee + accommodation package selection up to the point of deposit payment.En suite Bathroom .950 in each subsequent academic year of study to cover the cost of their tuition fees.uk. duvet.Single or Shared Bathroom .950 UG: £7. duvet cover.Off-Campus .500 8. STANDARD ACCOMMODATION * SUPERIOR ACCOMMODATION * PREMIUM ACCOMMODATION * . 1) The cost of your tuition fees for the academic year.En suite Bathroom . 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. 5/5 .8.450 UG: £8. 2) Standard accommodation from September 2012 to June 2013. 1) The cost of your tuition fees for the academic year.Free Welcome Pack on Arrival (includes . duvet cover.3 Although we endeavor to match your selection preference at all times this may not always be possible. a mattress cover. 8. UG: £8.uk. a mattress cover.5 £500 discount may be offered as partner scholarship to students from our partner institutions.400 MBA (1 year course): £9.glyndwr. For further details about the accommodation packages we offer please refer to the ‘International Student Accommodation Guide’ which is available online at www. the option by default will be Option 2 * All undergraduate students must pay £7. duvet.On-Campus .400 MBA (1 year course): £10. Please select which tuition fee + accommodation package you would prefer.

.. including all supporting documents. You must also tick this box if you are currently serving a prison sentence for a relevant criminal conviction. I understand that the information on this form is confidential..... to an official Glyndŵr University representative in your home country....... including all supporting documents.. Wales.......uk....….... If you fail to disclose a relevant conviction. 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.. I confirm that I have read........ Plas Coch. to us at: International Office. 6/5 ...... Email a scanned copy of the application form.......... Post the completed application form...... but may be passed to official UK government bodies to assist them in their duties if requested. Details of our representatives can be found at http://www.... Signed……………………………………………………………………. Declaration I certify that the details I have provided and any other supporting papers are true and accurate. Date……………………………………………………………………..... Mold Road... Submitting your application to the University There are three ways in which you can submit this application form to us: 1.. ………………………………………………………………………………... any offer that has been made to you will be withdrawn from the University.. Wrexham........ac...... 10.9. Glyndŵr University..... 7. Additional Needs Do you have any disabilities......ac........ 3.uk.. 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....... 2.. Submit your completed application form.glyndwr. United Kingdom. LL11 2AW. understood and fully Glyndŵr University’s International Fee Regulations 2012/13 policy. or for offences involving supplying controlled drugs or substances where the conviction concerns commercial drug dealing or trafficking. whether of a violent or sexual nature.............. including all supporting documents to: international@glyndwr....... 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...