Immigration Information Form

Applicant Details
LSBU ID

Name

Date of Birth

Programme
Before completing this form, please read the document ‘Tier 4 Sponsorship and the issuing of
Confirmation of Acceptance for Studies (CAS)’ which outlines LSBU’s position on the issuing of CAS
to students: https://my.lsbu.ac.uk/my/applicant/Current-Applicants/Regulations
Please answer all questions and sections which are relevant to you. Please state ‘N/A’ if the
question is not applicable to you.
It is essential that you complete this form. The information is required in order to
proceed with your admission to and enrolment at the University. Your offer may be withdrawn if you
already hold an offer and fail to submit this form.
Please attach all relevant documentation regarding your immigration history (e.g.
copies of all UK visas, enrolment/CAS letters, completed UK qualifications, permission to switch,
refusal letter, appeal letters, academic progress, Home Office correspondence etc. as appropriate)
Have you previously applied for a visa to enter
or remain in the UK?
Where are you planning to submit your visa
application from?
Have you ever had a visa refused?
Yes
Inside the UK
Yes
No
Outside the UK
Have you ever taken an ETS TOEIC English
language test?
Have you got any dependants?
Yes
Yes
No
No
Country:______________
Number _____
No
Do you currently have a visa application
pending with the Home Office?
Yes
No
If you have had a visa refused please send us a copy of the refusal letter and give details in the box below:
Notes
Immigration Information Form
 Important:
If you have previously applied for a visa to enter or remain in the UK, please include details of all UK visas that you have been granted, and
complete the form clearly and accurately. For non-Tier 4 visas (e.g. Visit, Tier 2) you only need to complete the first three columns highlighted in
bold.
 Give as much information as you can in the table below. There is space below to give more details should it be necessary.
Visa type (1)
Visa start
date
Visa end
date
(1) e.g. Tier 4 Student, Student Visitor,
Student visa, Tier 1 Post Study Work
visa
Name of Course Visa Institution name
was issued for
Level of study
(2)
Course
start date
(actual) (3)
(2) e.g. Please include the NQF level, or if you studied English Language Course the
CEFR level e.g. B1 or B2. The level of Study will be stated on previous CAS Statements.
Course
end date
Qualifications completed whilst
on this visa e.g. PGDip, BSc, MSc
(3) Please state the actual course start date. This maybe
different to what is stated on the course CAS statement.
Immigration Information Form
If any of the following apply to you, please give a detailed explanation in the Notes box below:
1.
2.
3.
4.
There are gaps in your immigration history;
You have failed to complete a course that you were sponsored for;
You completed a course for which you were not originally sponsored for;
Any further relevant information you would like to state
Notes
By signing below you assert the following:
-
I have read and understood the document ‘Tier 4 Sponsorship and the issuing of Confirmation of Acceptance for Studies (CAS)’ (available here:
https://my.lsbu.ac.uk/my/applicant/Current-Applicants/Regulations)
I have attached all relevant documentation regarding my immigration history. (Including, but not limited to: copies of all UK visas, enrolment/CAS letters, completed UK qualifications, permission to switch, appeal letters, academic progress, Home Office correspondence etc. as appropriate.)
I confirm that the information given in this form is correct and complete. I understand that the University reserves the right to withdraw any offer or cancel a
registration made on the basis of the information which proves to be false or misleading.
Signature: (must be hand written*)
Date: (must be hand written*)
_______________________________________
__________________________________________
*Electronic signatures are not accepted