KingstonUniversity London

Fee Assessment Questionnaire 2.OLA Entry

Section1 Personal Details
New Kingston Applicant: Kingston Student:fI Current Not YetApplied Kingston: to E

Page of 5 1

Month ,"r*' of

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Name:

ofEntry:

2 O ft Surname: USn Af+ Date ,t"n, of

Kingston Number: lD

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Email Address: Address:

Haveyou livedat this address the last6 years? Yes for givedetails all your previous lf you answered please No, of address(es) 1" September from 2004to present:

Pleose continueon o sepsrote sheetif required EMPTOYMENT/EDUCATION l't September2004to present from Employer/Education Provider

Pleqse continueon o separatesheet if required

FeeAssessment Team,Applicant Kingston Services, University, CooperHouse, 40 - 45 SurbitonRoad,Kingston UponThames, Surrey, KT12HX Email:feestatus@kinsston.ac.uk Tel:08448552177

KingstonUniversity London
Page of 5 2 Sectionl continued
(as Nationality statedin your Passport): Countryof Birth AT(f.UANISTI+N Haveyou everresided outsideof the UnitedKingdom lslands/European & Union? vesE/ruo Eldl'

V,

lf you answered pleasecontinueto section2 YES, lf you answeredNO,pleasecompletethe declarationbelow and return the form to us alongwith a copy of your passport.
I declorc that the inJormationt hove given is both true ond complete.I understond that giving inaccurateor folseinformotion, or submitting falseor froudulent documentation will offect my obility to enrol or remoin on o course of study at the University. I also understond thot the lJniversity requires further documentoryevidenceto verify this informotion ond thot foiture to produce thismoy resultin my being chorged Overseos fees.t understondthat the University is unoble to occept responsibility for ony original documents submitted with thisform. I confirm thot I havepermanent right ol obode in and have never lived outsideof the united Kingdom/EuropeonUnion.

sisnature: {y

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lf youanswered to the question NO above, form is nowcomple/e this

Underthe DataProtection 1998,the informationyou supplywill be held in strict confidence the purposeof ascertaining status Act for fee only pnd may be viewedby you subject written requestand a minimalfee. to

Section2 FamilyDetails
Please statethe nationality the following of (as individuals statedin their passport): Mother: Father: L e g a l G u a r d i a n ( s )x r l A , : Berf(SH 3grtsil

spouse:

/l providedetailsofyour parents/legal Please guardian(s) address{es) from 1't September present: 2004to

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Pleose continueon o sepctratesheetif required yourfamilymembers Have workedin the UK?yes E No E ff yes,please givedetailsbelowfrom 1't September 2004to present: Family member From To Employer/Education Provider

n,/x
Country

Please continueon o seporate sheetif required

FeeAssessment Team,Applicant Services, Kingston University, CooperHouse, 40 - 46 SurbitonRoad,Kingston UponThames, Surrey, KT12HX Email:feestatus(akinsston.ac.uk el:08448552177 T

KingstonUniversity London
Page of 5 3 Section3 lmmigrationStatus
Please belowwhichimmigration tick status applies you,please to alsonotewhat documents are required sendto us. you to

lmmigrationStatus
EEA (for a full list of EEA National countries please page1) see Marriedto a UK/EU Citizen

Please as tick appropriate

Documentation Required
A copyof relevant page(s) passport of details confirming nameand Nationality A copyof relevant page(s) passport of details confirming n a m e n dN a t i o n a l i t y . a A copyof relevant passportrdetails page(s) Spouses of confirming nameand Nationality Copyof marriage certificate.

Certificate Entitlement Rightof Abodein of to t h EU K Indefinite Leave Enter/Remain the UK to in

A copyof relevantpage(s) passport of detailsconfirming nameand Nationalityand/orrelevanthomeofficeletter A copyof relevant page(s) passport of details confirming nameand Nationality a copyof your Indefinite and Leave to Remain

Asylum Seeker

A copyof relevantpage(s) passport of detailsconfirming nameand Nationality relevant and homeofficeletter

Refugee Status

A copyof relevantpage(s) passport of detailsconfirming nameand Nationality relevant and homeofficeletter A copyof relevant page(s) passport of A;tail, confirmrng nameand Nationality including copyof yourVisa and a

Visitorto the UK

Student

A copyof relevantpage(s) passport of detailsc;tfir;ing nameand Nationality including copyof yourVisa and a A copyof relevant page(s) passport of Oetails coniirming nameand Nationality including copyof yourVisa and a

Work Permit Holder

Dependants Visa,for example a spouseor of parent

A copyof relevantpage(s) passport of O"iiGionfirrine nameand Nationality including copyof yourVisa and a A copyof relevantpage(s) passport of detailsconfirming nameand Nationality including Visa the person and any for on whichyou are dependant

FeeAssessment Team,Applicant Services, Kingston University, CooperHouse, 40 - 46 SurbitonRoad,Kingston UponThames, Surrey, KT12HX Emaif:feestatus(akinsston.ac.uk Tel:O844g5S2!77

KingstonUniversity London
Page of 5 4

Section 4 Refugee Status AsylumSeeker I

Are you an Asylum Seeker awaitinga decision from the HomeOffice? Yestr Are you a refugeerecognised Her Majesty's by Government? Yesn No { No p/

you beenordinarily Have resident the UK(including Channel in you were recognised a the lslands lsleof Man)since and as refugee? YesE Nofu./ Doyou havea relevant familymemberwho is recognised a refugee the UK? as in lf so,please statetheir relationship you to you beengranted Have anyof the following, a resultof an Asylum as Application?

Doyou havea relevant familymemberwho hasbeengranted anyof the following, a resultof an Asylum as Application? lf so please statetheir relationship you to

details:confirming namgand Nationality

Section5 Temporary Residence Abroad

r.t, /tl

you or a familymemberresided Have outside the UK/EU/EEA/Switzerland/Overseas of Territories since September 1't

2006? tr Notr/ Yes

Whendid you leave UK/EU/EEA/Switzerland/Overseas the Territories? ln whichcountrydid you resideoutsideof the UK/EU/EEA/Switzerland/Overseas Territories?

FeeAssessment Team,Applicant Services, Kingston University, CooperHouse, 40 - 46 SurbitonRoad,Kingston UponThames, Surrey,KT12HX Emaif:feestatus@kinpston.ac.uk Tel:0844 855 2t77

KingstonUniversity London
Page of 5 5 Section5 Continued
a) Whatwasyour reason this residency? for b) fn whichcountryare you ordinarilyresident? rJ / A

fw / l,

c) lf you were not residing outsideof the uK/Eu/EEA/switzerland/overseas Territories, where would you havebeen ordinarily resident? d) Do/didyou makeregularreturn visitsto the UK/EU/EEA/switzerland/overseas yes Territories? D e) Doyou or your familyown a propertyin the UK/EU/EEA/Switzerland/overseas yes Territories? D No D No E

f) lf so,did you maintain this in the periodof time that you resided outside the uK/EU/EEA/switzerland/overseas of Territories? E Yes No E

Declaration

I declorethat the informotion I hove given is both true ond complete.I understand that giving indccurate folse informotion, or submitting or folse or Jroudulent documentotion wil! affect my obility to enro! or remoin on a courseof studydt the Llniversity. I olsounderstond thot the llniversity requires further documentoryevidenceto verifu thisinformation ond thatfailure to produce thismay resultin my being chorged overseosfees. understondthdt the I University is unoble to occept responsibility for any original documentssubmitted with this form.

Signoture:

Dote:

under the DataProtection 1998,the informationyou supplywill be held Act in strict confidence the purposeof ascertaining statusonly and may for fee be viewedby you subjectto written requestand a minimalfee.

Thisform is now complete

FeeAssessment Team,Applicant Services, Kingston University, CooperHouse, 40 - 46 SurbitonRoad,Kingston UponThames, Surrey, KT12HX Email:feestatus@kinsston.ac.uk el:0944g552177 T