TIER 5 (GOVERNMENT AUTHORISED EXCHANGE) CERTIFICATE OF SPONSORSHIP
DRAFT INITIAL APPLICATION FORM
The information requested in this form is required to enable the Department of Materials to apply for a “Tier
5 (Government Authorised Exchange) Certificate of Sponsorship Initial Application” on your behalf.
Please complete this form and return it electronically, with the necessary supporting documents listed at
the end of the form, to the Head of Department’s office – carol.spruce@materials.ox.ac.uk. (Hard copy
application not required.)
Passport Information
Please complete as much of the following personal information in full as it appears in your passport, and the
additional information whether or not it appears in your passport (e.g. for US citizens city of birth):
Title (e.g. Dr, Mr, Mrs)
Last name
First name(s)
Other name(s) – [i.e. previous name]
Nationality
City of birth
Country of birth
Date of birth
Gender
Passport number
Passport issue date (DD/MM/YYYY)
Passport expiry date (DD/MM/YYYY)
Passport place of issue (city / country)
Sponsored researcher contact details
Country of residence
(This must be the country in which the
researcher will apply for a visa):
Full residential address, including post
code / zip code / area code
(This must be the address where the
researcher lives (not works) in the country in
which the visa application will be made.)
Email address:
Identification Numbers
UK ID card number (if applicable)
UK National Insurance number (if
applicable)
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National ID card number (if applicable)
Visit details
Start date (DD/MM/YYYY)
(To match the start date of the research visit.)
End date (DD/MM/YYYY)
(To match the end date of the research visit.)
Does the researcher require multiple
entry to the UK for work purposes?
No
Note: Researchers who will only travel overseas for
domestic and leisure purposes do not require a
multiple entry visa.
Total weekly hours of work:
35 or 40
Full work address in the UK (including
postcode)
Department of Materials, University of Oxford,
Parks Road, Oxford, OX1 3PH
Other regular work address(es)
Department of Materials, University of Oxford
Banbury Road, Oxford, OX1 3PH
(In which building will the visitor mainly be
based?)
Department of Materials, University of Oxford
Begbroke Science Park, Woodstock Road, Begbroke, Oxon.
OX5 1PF
Job Title (e.g. sponsored researcher,
visiting researcher)
Sponsored Researcher
Title of research subject:
To be completed by host – example:
3D visualisation of freshwater algae exposed to engineered
nanomaterials of different surface functionalisations using
nanoscale mass spectrometric methods (NanoSIMS).
Genuineness Test:
To be completed by host – example:
Research activities now subject to a “genuiness
test” by UKBA – please give comprehensive
information max. 700 characters, included title.)
Studying the interaction of simple biological organisms
with engineered nano-particles is an important way to
understand the impact that these new materials might
have when introduced into the natural environment by
human action. The home laboratory of the visitor has
expertise in the synthesis and functionalisation of nanoparticles, and the Oxford host group are experts in the
ultra-high resolution SIMS analysis of trace elements in
plants.
Gross funding
£
per
Gross allowances
£
per
Description of allowances (e.g. £1,000
travel, £1500 accommodation)
Details of Funding Body
Full name of organisation funding the
visit
a
Full name of representative of the
funding organisation
Position in organisation
Telephone number
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Email address:
Supporting Documents
Please make sure that electronic copies of the following documents are attached:

Copy of photo and personal information page(s) and any UK visas in a valid passport

Copy letter from the funding organisation stating the specific start and end dates of the “research” visit to the
“University of Oxford” and the level of funds and allowances (if applicable) that will be paid to the sponsored
researcher for the duration of the visit.

Copy of Curriculum Vitae

Copy of original certificate of award for the highest qualification achieved, with translation (if applicable), translated by a
certified translator, if not in English.
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