York Grove Student House factsheet

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Student Details

First name

Last name

Email

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Phone number

Second Phone number (optional)

Skype ID (optional)

Date of birth

Gender

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Nationality

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Country of residence

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Own language

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Address line one

Address line two

Town / city

Postcode

Country

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Your level of English

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Passport number

Passport expiry date

Upload photo ID page of passport

Type of visa required

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Have you previously held a Tier 4 Visa?

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Do you currently hold a Tier 4 Visa?

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Health and medical information
Ongoing illness and/or any medication being taken (e.g. asthma, epilepsy, diabetes), Special Educational needs (e.g. dyslexia), Special diet (e.g. severe allergies, coeliac, vegetarian, vegan, Halal)

If you are not a US citizen, or lawful permanent resident, and you already have a visa, please indicate the type

Have you been ever academically dismissed?

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Do you have a criminal record? (except traffic violation)

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Previous education

Please state your country of main education

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Most recent school attended

Name

Address

Town/city

Country

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Date attended from

Date attended to

Qualification/s received (if multiple, please list up to four subjects with grades achieved)

Please upload a translated copy of your latest academic results

Activities, interests and personal achievements

Future educational plans

Academic interests

Athletics

Extracurricular activities

Awards and recognition

Any documentation/award certificate you received

Upload a personal statement covering all the above topics

Upload a letter of recommendation

Upload a second letter of recommendation

Parent/Guardian/Fee payer details

Name of parent/guardian

Is the fee payer different from the parent/guardian?

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If you are government sponsored for your studies, please provide name of sponsor:

Home address line one

Home address line two

City

Postcode

Nationality

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Acceptance of terms and conditions

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Family Educational Rights and Privacy Act (FERPA) Waiver: Authorization for release of information

For the purpose of allowing others to assist me with my education, Kings and my chosen host college/university may release information in my student record as necessary to facilitate evaluation, transfer, credit or management of my application, enrollment and continued progress at Kings or my chosen host college/university. This authorization specifically permits the sharing of information in both directions between Kings and my chosen host college, and from those parties to any person named below, who is directly responsible for my recruitment or continued participation in the On Campus Plus Program at my chosen host college/university. I understand that I have the right to revoke this authorization at any time.

I authorize Kings and my chosen host college/university to release information in my student record

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I, the student, certify that all information submitted by me in this application is my own work, and is complete and accurate to the best of my knowledge. I understand that any misrepresentation or omission of facts in my application justifies a denial or cancellation of admission. I hereby apply for the programme and confirm I have read and accepted the Terms & Conditions.

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I, the parent or sponsor, certify that all information submitted by me in this application is my own work, and is complete and accurate to the best of my knowledge. I understand that any misrepresentation or omission of facts in my application justifies a denial or cancellation of admission. I hereby apply for the programme and confirm I have read and accepted the Terms & Conditions applicable to my chosen host college/university.

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Kings Brighton York Grove Student House Factfile

Contemporary student house
located close to the school

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Kings Brighton York Grove Student House Factfile

Contemporary student houselocated close to the school

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Student Details

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Activities, interests and personal achievements

Parent/Guardian/Fee payer details

Acceptance of terms and conditions

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Step inside life at Kings.
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Contemporary student house
located close to the school