Student Reference Number:

Plymouth University Postgraduate

International Student Application Form
(Office use only)

If handwriting this form please use CAPITALS

1. Programme of Study
Start date (month & year)

Postgraduate taught course Postgraduate research course

Title of course (full title as per web site) (Or research proposal title)

2. Personal Details
Family name (exactly as written in passport)

First name(s) (exactly as written in passport)

Title Mr / Ms / Mrs / Miss / Other

Date of birth (dd/mm/yyyy) Gender

Male Female
Country of birth Nationality

Country of permanent residence

Have you ever studied at or applied to Plymouth University or Plymouth University

International College (PUIC) before?
No Yes
Please state previous student
reference number:

3. Contact Info
Correspondence address Home address
(if applying via agent please put agency stamp / address here) (if different from correspondence address)

Personal email (must be completed)

Agent email (if applicable) Personal tel (home)

Agent code (if applicable) Personal tel (mobile)

4. Confirmation Checklist (please read and mark X to confirm)
 I have checked on the www.plymouth.ac.uk website that my chosen course(s)
is / are offered on a full-time basis (international students who require a Tier 4 visa only).
 I have checked on the www.plymouth.ac.uk website that my chosen course(s)
is / are open to international student applications.

5. UKVI / Visa Info

Applicants not born in the EU please state if ever entered UK / EU previously:
No Yes From
(give dates – continue on a separate sheet if necessary)
To
Do you require a Tier 4 visa to study in the UK?
(If not sure please see Immigration & Visas section of www.plymouth.ac.uk/isas) Yes No
Have you studied in the UK previously on a Tier 4 or
other type of visa (including all studies, whether completed or not)? Yes No
If answered Yes to above please give details in full below
(continue on a separate sheet if necessary)

Name of university / Course title Qualification Type of visa Dates of study

college (& NQF level if held
known) From To

Please note that, due to UKVI regulations, there is a time limit on studies in the UK on Tier 4 or pre-Tier
4 visas. If the period of your studies at Plymouth University would mean you will exceed this time limit
the University may not be able to offer you a place. Please see www.ukba.homeoffice.gov.uk/ for details
or ask us for further clarification during the admission process.
Please see https://www.gov.uk/guidance/immigration-rules/immigration-rules-appendix-c-maintenance-
funds for guidelines on Tier 4 maintenance (funds) and other requirements.

6. Academic Qualifications (continue on separate sheet if necessary)

Name of Level / qualification Course title Grade / Date
institution studied (include result completed
NQF level if known) obtained

7. English Language Qualifications (please attach test result document)

IELTS total Reading Writing Listening Speaking
Date taken
PTE total Reading Writing Listening Speaking
Date taken
Other – please specify all scores and date taken
If you do not meet our English language requirements you may be eligible for one of our pre-sessional
English courses: www.plymouth.ac.uk/international

8. Work / Professional Experience

Please attach your CV to the application (if applicable).
9. Personal Statement
Please attach your personal statement to this application.
The Personal Statement should detail in essay form your motivations for applying to Plymouth University for the course(s) you
have chosen, including your interest in the subject(s), any study and / or work experience relevant to the subject(s), plus other
activities you have done and / or skills you possess relevant to the subject(s). Please also include your career aims upon
completion of this course. Please submit as a Word / other typed document and include your full name.
10. References
Please submit two references, at least one from an academic who has taught you. Please submit these
as original documents on headed paper in sealed envelopes with your application. Alternatively, your
referees may scan and email the letter on headed paper directly to the University from their official work
email address.

11. Interviews
Where it is required and feasible to do so, some departments will interview applicants before
recommending admission. This may be a telephone / Skype interview. The University will contact you in
regard to this if applicable.
 12. Funding Information
Who will pay your fees?
You or your family Government Employer Other
body
Please provide details here (or attach sponsorship confirmation to your application)

13. Criminal Convictions

Do you have a criminal conviction? Yes No
If yes give full details (continue on a separate sheet if necessary)
14. Document Checklist (check √ when done)
All relevant high school, college, Proof of English language level Personal Statement
university transcripts and
certificates, plus any relevant
professional qualifications
(for courses not yet completed please
submit all available transcripts)
Copy of information page from current 2 Reference letters Postgraduate research only:
passport and any UK visas held (at least 1 from an academic Research proposal
previously who has taught you)

CV Evidence of written work (Creative Writing Form fully

students) or portfolio completed and signed
(Art / Design / Architecture
students)

15. Declaration and Signature of Applicant

- ONLY to be completed once this form is fully completed and all items on Document Checklist in section 14 are included.
- The applicant must personally review and sign this section before submitting.
 If applying via agent: I confirm that the University can correspond with my agent regarding my
application as appropriate. I also confirm that this agent is the sole agent I will use to facilitate
my application to, and any subsequent preparations to study at, Plymouth University.
 Tier 4 students only: I confirm that, if I am accepted by Plymouth University, I will personally
complete the pre-CAS checklist.
 I understand that I may be requested to submit further documentation in support of my
application.
 I confirm that, to the best of my knowledge, the information given in this application form is
complete and correct, and that the submitted documents are genuine.
Applicant name: Date (dd/mm/yyyy):
Signature (or electronic signature; re-
type full name here):
16. How to Submit Your Application
Please email completed application form and all supporting documents to:
For taught programmes: For research programmes:
international-admissions@plymouth.ac.uk doctoralcollege@plymouth.ac.uk
Or post to: Plymouth University Admissions, Drake Circus, Plymouth PL4 8AA, UK

Appendix to International Student Application Form

Thank you for making this application.
Please read the info and tick the boxes within the fields on this and the next pages to complete the form.

Ethnic Origin
As a requirement of the Race Relations Amendment Act (2000) we need to know your ethnic
origin for the purpose of monitoring equality of opportunity to all ethnic groups, highlighting
possible inequalities and enabling the implementation of action to remove any barriers and
discrimination.

Please select from the categories below – these categories are approved by the Commission
for Racial Equality and the Higher Education Statistics Agency:
[10] White

Mixed

[41] White and Black Caribbean

[42] White and Black African

[43] White and Asian

[49] Any other mixed background

Asian or Asian British

[31] Indian

[32] Pakistani

[33] Bangladeshi

[39] Any other Asian background

Black or Black British

[21] Caribbean

[22] African

[29] Any other Black background

Chinese or other ethnic group

[34] Chinese or any other Chinese background

[80] Other ethnic background

[90] Not known

[98] Do not wish to answer

All information in this form correct at time of publication but may be subject to change. For
latest version of the form please visit www.plymouth.ac.uk
Admissions Tel +44 (0)1752 585 858 Doctoral College Tel +44(0)1752 232 786

Most Taught Courses Application Deadline: 31st July*

*see www.plymouth.ac.uk/international for information.
Research applications can be made year-round. Applications received after the
deadline will be considered for the next available entry point.
Disability Monitoring Form
Dear Applicant

IMPORTANT: PLEASE NOTE

If you have a disability

The University is very supportive of students with disabilities, and year-on-year we are
making adjustments to assist students with special arrangements. It may be that we
have already put in place changes which will assist you – but unless we know what
your needs might be, we cannot guarantee that that will be the case. If we can identify
your needs sufficiently far in advance of when you intend to start a course at the
University, we are better able to put in place appropriate arrangements – or, if there is
a health and safety issue or an issue about the expectations of students on the course,
to advise you on alternative options. However, we may not be able to do so if we do
not know in advance.

Please tell us about your disability

Please tell us about your disability, if you have one, by completing and returning the
Disability Monitoring Form with your application form. Please note that all offers are
made on academic grounds. You may be asked for additional information or invited to
attend an interview with Disability Assist Services. This is in order that we can properly
assess your individual needs and ensure that we have the best possible chance of
meeting them. Please do provide any information requested and come in to see staff if
asked to do so, since otherwise you – and we – could find ourselves in a position in
which it is difficult or even unsafe for you to take up your place.

If you choose not to tell us about your disability

You may not wish to disclose your disability at this point. However, we may not be able
to meet your individual needs if we do not have the opportunity to assess them in
advance, and that could impact on your experience of the course or even your ability to
take up your place.
You may feel that you would prefer to speak to someone confidentially about
disclosure or that you require further information to help you decide. If this is the case,
please telephone +44 (0)1752 587 676 or email Disability ASSIST Services on
das@plymouth.ac.uk

So please tell us about any disability – even if you do not think it will affect you
while you are at the University – and respond positively to any requests for
further details or for an information interview. If you do not do so, you may find
yourself unable to take up your place or unable to complete the course because
we have not been able to adequately to meet your particular needs.
 Disability Monitoring Form
Personal Details
1. Last / Family Name: 2. First Name:

3. Date of Birth (dd/mm/yyyy): 4: Nationality:

5. Gender: 6. Are you married?

Male Female Yes No
Disability
7. Please tell us if you have a disability, medical condition or dyslexia.
[A] No disability

[B] You have a social/communication impairment such as Asperger’s syndrome/other autistic

spectrum disorder

[C] You are blind or have a serious visual impairment

[D] You are deaf or have a serious hearing impairment

[E] You have a long standing illness or health condition such as cancer, HIV, diabetes, chronic
heart disease, or epilepsy

[F] You have a mental health condition, such as depression, schizophrenia or anxiety disorder

[G] You have a specific learning difficulty such as dyslexia, dyspraxia of AD(H)D

[H] You have a physical impairment or mobility issues, such as difficulty using your arms or are
using a wheelchair or crutches

[I] You have a disability, impairment or medical condition that is not listed above

[J] You have two or more impairments and/or disabling medical conditions

8. Do you receive Disabled Students’ Allowance (DSA)?

[4] I have a disability and am in receipt of DSA

[5] I have a disability but do not receive DSA

[9] I have a disability but have not applied for DSA

Disability Disclosure
Yes
I agree to relevant information about my disability and/or support arrangements being
disclosed to those lecturing and administrative staff who have a need to know. In the event that
I do not take up a place I understand that this information will be shredded within a reasonable
period.
No
I do not agree to disclosure about my disability and understand that this may limit the support I
receive. I agree to inform Disability ASSIST Services if I reconsider this decision.

Signature: Date (dd/mm/yyyy):