FEES ASSESSMENT QUESTIONNAIRE

Please read the notes which accompany this form (‘Notes on Assessment of Fees’) before completing ALL
sections. Please write clearly and in capitals.

Section 1 – Personal Details

Mr/Mrs/Miss/Ms/Other (please specify) Date of birth_________________________

Family Name ____________________________________________________________________________

First Name(s) ___________________________________________________________________________

Current address _________________________________________________________________________

Home address ___________________________________________________________________________

(if different from current)
______________________________________________________________________________________

If you or your family maintains any property other than the address(es) given above, please provide address
below:

_______________________________________________________________________________________

_______________________________________________________________________________________

Email address ___________________________________________________________________________

UCAS Number/Applicant Number (if applicable) ________________________________________________

Title of proposed course of study ____________________________________________________________

Course code Date of commencement of course _____________________________

Are you employed in the United Kingdom? YES/NO (delete as appropriate)

If YES, please give details (eg start date, type of contract (temporary or permanent), number of hours
per week, name of employer):

_______________________________________________________________________________________

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Section 2 – Family Members

a) For each of the family members listed in the table below, please provide the information requested.
Please use ‘N/A’ to indicate ‘Not Applicable’ where appropriate.

Family Member Nationality Country of normal Country where

residence employed
Father

Mother

Spouse or civil partner*

Children

* A civil partnership is a legally recognised union between same-sex couples. Please do not include details
of a partner unless the partnership is a legally recognised union (ie marriage or civil partnership).

b) Do you have any other family member who is a European Union national and who is exercising a right of
residence in the UK as a self-sufficient person or as a student?

YES/NO (delete as appropriate)

c) If YES:

Please give the name of that family member:_________________________________________________

Please indicate the relationship of that family member to you: ___________________________________

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Section 3 – Your Immigration Status

a) Your Nationality: _____________________________________________________________________

b) Please tick the appropriate box in the following table to indicate your current status, and provide with
your completed questionnaire the document(s) requested:

Immigration Status Please provide:

 British citizen or Commonwealth national with Right of Copy of page(s) of passport confirming
Abode name and nationality

 European Economic Area (EEA) national (other than UK)

or a Swiss national. The EEA comprises: Copy of page(s) of passport confirming
United Kingdom, Austria, Belgium, Bulgaria, Cyprus, name and nationality
Croatia Czech Republic, Denmark, Estonia, Finland,
France, Germany, Greece, Hungary, Iceland, Italy, Latvia,
Liechtenstein, Lithuania, Luxembourg, Malta,
Netherlands, Norway, Poland, Portugal, Republic of
Ireland, Romania, Slovakia, Slovenia, Spain and Sweden

 Indefinite Leave to Enter/Remain Copy of relevant page(s) of passport

(including page(s) confirming name and
nationality) and/or Home Office letter
 Refugee status UK Border Agency/ Home Office letter
OR or refugee travel document
 you are the child, spouse or civil partner of someone with
refugee status

 Refused refugee status but granted humanitarian UK Border Agency/Home Office letter
protection
OR
 you are the child, spouse or civil partner of someone
refused refugee status but granted humanitarian
protection

 Time limit on stay

Date last passport stamp/visa was issued:

Date of expiry of most recent permission to

stay:

If none of the above categories cover you, or if your status is likely to change before the start of your
programme of study, please give details and provide supporting evidence:

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Section 4 – Your Residence

a) Please list below the countries in which you have lived lawfully (not in breach of immigration conditions)
for the past 20 years (or from birth if you are aged under 20 years old), giving dates (month and year),
and the main reason for your residence in each - continue on a separate sheet if necessary.
Please include at least 17 years up to the present day.
Country Dates lawful residence Main purpose for living
began and ended in specified country
to

to

to

to

b) Are you an EEA national (see EEA member countries above) who has been living outside the EEA on a
temporary basis? _If yes, please list on a separate sheet the dates, length of stay and location of any visits
you have made back to your permanent home in the EEA during this temporary absence. Also provide
any relevant documentary evidence to show that your residence abroad was temporary (eg travel
documents, utility bills for your EEA home, employment contract etc).
IMPORTANT – _Failure to provide this information may result in your fee status being
assessed incorrectly and you being charged the full economic fee for the course

c) If the main purpose for your residence in the EEA, Switzerland or Overseas Territories during the last 3
years was education, was this because your spouse, civil partner or a parent was temporarily employed
outside the EEA, Switzerland or Overseas Territories?

YES/NO/Not applicable (delete as appropriate)

d) In which country will you be living on the ‘first day of the first academic year’** of your programme of
study? _______________________________________________________________________________
_** The ‘first day of the first academic year’ of study is defined for the purpose of fee classification as
the 1 September, 1 January, 1 April or 1 July closest to the beginning of the first term of your course.
For undergraduate students, the ‘first day of the first academic year’ will normally be 1 September, but
for postgraduate students the date may vary.

Section 5 – Declaration

I certify that I have completed ALL sections of the questionnaire and that the information I have provided is,
to the best of my knowledge, correct.

Signature Date:_____________________________

Please now return this form, together with any supporting documents (eg copy of relevant page(s) of
passport, list of visits back to permanent home, copy of employment contract, utility bills etc) to:

Undergraduate Admissions Team, Marketing and Student Recruitment Directorate,

Newcastle University, King’s Gate, Newcastle upon Tyne, NE1 7RU

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