University of Bedfordshire

UK Immigration History Form– to be completed by the applicant/student

This form must be completed by all applicants/students who have been in the UK on a visa
(not including visitor visas for tourism purposes)

Name: _____________________________________________________

Student reference number_____________________________________

 Full UK Immigration History (starting with most recent UK leave to remain – you
MUST provide copies of all UK visas).

Visa Number Visa Type Valid From Valid To What Institution For

Example Tier 4 Student 15.08.2010 31.11.2011 University of Oxford

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  Full UK Academic History (starting with most recent studies- please provide copies
of CAS letters from all the places you have studied at. If you do not have the CAS letters
please provide any other letter from the institution which confirms details of the
course you studied with them).

Name of Type of NQF Start Date End Date of Date of last Copies of Evidence
Institution Course Level of course course attendance Visa Provided (copies of
Provided previous CASs,
(tick box) enrolment
letters/student status
letters and
transcripts/certificates)
Please tick box
University of Foundation 15/01/2012 20/12/2012
Oxford Course in Y N Y N
English

Are you currently in the UK?

o Yes

o No (please provide copy of your passport showing most recent entry stamp to home
country)

Did you ever receive a curtailment letter from UKVI? (This is a letter from the UK Home Office to
say that you have a new visa expiry date)

o Yes (please provide a copy of the letter)

o No

Do you have a previous visa refusal letter?

o Yes (please provide a copy of the letter)

o No

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 Declaration:

I confirm that, to the best of my knowledge, the information given in this form is correct and
complete.

I grant permission to the University of Bedfordshire to request information pertaining to my

current or previous visa status in the UK from the Home Office if necessary.

Name (Please print) _________________________________

Student reference number ____________________________

Passport number _________________________ Date of birth _____________________

Signature: _________________________________________ Date: ________________