Fee Assessment Questionnaire

Fees Assessment Questionnaire UK government legislation allows publicly funded educational institutions to charge ‘Overseas’ student fees to students unless they fulfil certain residence and immigration requirements. If you meet these residence and immigration status requirements you will be charged a lower ‘Home’ student rate. You must also be charged the Home rate if you meet certain requirements that apply to groups such as EU nationals or refugees. Details of these requirements can be found at: www.ukcosa.org.uk. If you have received this questionnaire as part of an offer you must respond within four weeks of receipt. Not doing so may result in an automatic Overseas classification. Please complete the following to help us assess your fee status. It should be returned to: Registry Services, e-mail: [email protected] George Thomas Building (37) University of Southampton, Fax: 023 80 59 5490 Highfield, SO17 1BJ. Section 1, 2 and 3 must be completed fully. Please also tick and date the declaration. 1) Personal Details Family name: First name/s: Title: Mr/Ms/Miss/Mrs/Dr Date of birth: DD/MM/YY E-mail: Phone: Programme of Study: Start date: Student ID (if known): Reference number / UCAS number (if known): Nationality/Citizenship: (If you are a citizen of more than one country, please list them all) Nationality of relevant family members: (If they are a citizens of more than one country, please list them all) 1) Mother: 2) Father: 3) Spouse / Civil Partner: or I am not married / not in a civil partnership Date of marriage / civil partnership? DD/MM/YY Are any of your other relevant family members EU / EEA Nationals? (Please List) 1 2) Immigration Status Please tick the option that applies to you, and Please provide the following with give the dates as requested: returned questionnaire: British Citizen or Commonwealth National with Copy of relevant page(s) of passport Right of Abode (including page(s) confirming name and nationality) Indefinite Leave to Enter / Remain Copy of relevant page(s) of passport (including page(s) confirming name and nationality) and/or Home Office letter Refugee status Home Office letter or refugee travel document Refused refugee status (or child or spouse of Home Office letter someone refused refugee status) but granted one of the following: □ Exceptional Leave to Enter / Remain □ Humanitarian Protection □ Discretionary Leave Time limit on stay Copy of relevant page(s) of passport (including page(s) confirming name and Date last passport stamp / visa was issued: nationality) Date of expiry of most recent permission to stay: EEA national, other than UK Copy of relevant page(s) of passport (EEA members: Austria, Belgium, Bulgaria, (including page(s) confirming name and Cyprus, Czech Republic, Denmark, Estonia, nationality) Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Republic of Ireland, Romania, Slovakia, Slovenia, Spain and Sweden) If none of the above categories covers you, or your status is likely to change before the start of the course, please give details and provide supporting evidence: 2 3) Residential History Date of first entry into the UK / EEA (if applicable): Please give details of the country / countries in which you have been resident since birth: (Please continue on a separate sheet if necessary) Country and town / Dates of residence Purpose of residence, e.g. Holiday, region of residence (from – to) living with family (specify Day/Month/Year relationship), employment, full-time study e.g. London, England 12/09/2003 to 01/01/2004 e.g. Living with Family (Mother) 4) Temporary Residence Abroad (Please continue on a separate sheet if necessary) If you have been ordinarily resident outside the UK and Islands or EEA during the last three years because you, your spouse / civil partner or your parent(s) were / are temporarily working abroad, please give details (including length of time spent abroad and the nature of the work). Please include a copy of the relevant employment contracts or an official letter from the employer covering this period. Country Length of Stay Nature of work Contract type (Including arrival date and leaving date, if appropriate) 3 Did you / your parent(s) / spouse / civil partner have the post abroad at time of departure from the EEA? Yes / No Do you / your parent(s) / spouse / civil partner pay tax contributions in an EEA country? Yes / No If ‘Yes’ please give details: Was / is a house or flat maintained in the EEA during the period of employment abroad? Yes / No If Yes, was / is it rented / retained for the family's use? Rented / Retained For Family Use Please give address, length of possession and provide proof of ownership (i.e. utility bills, documents/deeds of purchase, etc): How often have you (the applicant) visited the property in the last three years (please provide dates and length of stay): Do you/your parents plan to return to the UK / EEA on a permanent basis, and if so when? Use this space to add any other relevant information (continue on a separate sheet if necessary): 5) EEA / Swiss ‘Worker’ & Family Is there an EEA migrant worker / Swiss ‘worker’ in your family? Yes / No If the answer to this question is ‘Yes’ please select which of the following categories applies to you: Migrant worker Spouse / civil partner of a migrant worker Child of a migrant worker Child of a migrant worker’s spouse / civil partner The parent, grandparent (etc in direct ascending line) of an EEA (not Swiss) migrant worker AND dependent on the EEA migrant worker The parent, grandparent (etc in direct ascending line) of the EEA (not Swiss) migrant worker’s spouse / civil partner AND dependent on the EEA migrant worker or on the EEA migrant worker’s spouse / civil partner 4 6) Refugee/Asylum in the UK Please Tick any statement that applies to you and provide documentary evidence in support of this I have Refugee Status My Parent / adoptive parent / step-parent / guardian has refugee status My Spouse / Civil Partner has Refugee status I am an asylum seeker and I am waiting a decision from the Home Office or the result of an appeal I have Exceptional Leave to Enter/Remain in the UK I have been granted Humanitarian Protection in the UK I have been granted Discretionary Leave in the UK I have been given the right to stay indefinitely/settlement in the UK within the last three years Refused refugee status but granted one of the above If you have been given the right to stay indefinitely in the UK when were you given this? Checklist Completed Section 1 Completed Section 2 Completed Section 3 Completed all other relevant sections Provided all relevant documentation Please remember to enclose photocopied evidence outlining your status. This will help us process your application promptly. Declaration By ticking the box I hereby confirm that the information provided above is correct to the best of my knowledge. Date: DD/MM/YY 5 .

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