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Application Form (MS Word)
Application Form (MS Word)
Application Form
To apply, please complete this application form electronically and return it by email or print to complete and return it by post/fax. In either format the application form must be submitted with the following:
An academic referee who is a member of staff at your current or recent college or university Passport photo (one digital if emailed, or two printed if posted) Proof of current Grade Point Average (GPA/academic transcript) Proof of IELTS score or equivalent English skill, if applicable
Upon arrival, students must show their medical/travel insurance certificate and, if a national of a non-EEA country, a student visitor visa. The University can decline entrance to the programme without these.
Personal Details
First Name Known as Date of Birth Nationality Postal Address Line 1 Line 2 City Country Phone Number (including country code) Email Address How did you hear about the University of East Anglias International Summer School? Home Institution Study Abroad/HE Fair Other UEA Website Flyer Brochure Poster Postal/Zip Code Surname Gender Age at 1 July, 2012
[Minimum accepted age at 1 July is 18]
Educational Details
Current/most recent home institution Country of home institution Highest qualification achieved: Degree Major Current level and year of study (e.g. undergraduate 2nd year)
Award Date
You will need to provide documentation to support this with your submitted Application. Is English your first language Yes No
If English is not your first language, please provide proof of English proficiency. Level required is a minimum IELTS (or equivalent) score of 6.5. Please contact us before submitting an application if you do not meet the minimum requirement specified. Qualification Name Grade Received Award Date You will need to provide documentation to support this with your submitted Application. Academic referee First Name Institution Postal Address Line 1 Line 2 City Email Address Please ensure that your referee is willing to be contacted by the University should we need to verify your GPA or any other eligibility criteria. Country Postal/Zip Code Phone Number (including country code) Surname Relationship to Referee
Module Selection
Students will complete ONE 20 credit module during the International Summer School.
Our webpages will provide up to date information on availability. It may be possible to change preferences, subject to availability, after submitting an application. Places will be allocated on a first come first served basis with a deposit paid to secure choice(s) made. We recommend specifying a second and third option to secure a place on the Summer School. Please clearly specify module title as displayed at: www.uea.ac.uk/summerstudyabroad/modules
Module Supplement
Students selecting Spirituality and Identity in the UK OR Contemporary British Theatre will be required to pay a supplement of 495 to cover London accommodation and excursions. Please tick to secure London accommodation/academic trips: London Supplement (495)
Details of the London accommodation, academic trips and social programme in London are on our webpages. The supplement will be due with the programme fee balance by 31 May. The University reserves the right to withdraw the London element of the programme for the specified modules and relating supplement paid would be reimbursed in full.
Disabilities/Additional Requirements
The University welcomes students with disabilities and strongly encourages you to disclose any disability or medical condition which may impact upon your studies. This will not affect the academic decision about your application but will help us put any individual arrangements or facilities in place for the start of your study abroad programme with us.
Equal Opportunities
The University aims to create an environment for learning that is tolerant and respectful, providing equal opportunities for all. To assist with our monitoring please indicate your ethnic origin. This information will not be considered as part of the application process.
Other White background Other Black background Other Asian background White and Black African Other mixed background
Please tick one option: Package A (180) Package W1 (385) Deposit Due 100
No Additional Social Package (at time of booking) Package B (775) Package W2 (385) Package L (140) Package W3 (385)
Full payment will be due with the programme fee balance by 31 May. The University reserves the right to amend the dates of individual trips and in the event of a trip not running, an equivalent activity will be provided.
Fees
Once an application is submitted we will respond with the outcome of the application, if successful a deposit of 200 is required to accept and confirm a place on the Summer School. The deposit is non refundable. This will be deducted from the final balance.
To secure the early registration fee, applications and a deposit of 200 must be received by the University of East Anglia before 1 February 2012. Students currently studying at one of our Partner universities receive a 5% discount from the standard registration fee. Please check our webpages on the Fees page for full terms and conditions and Partner details.
Please tick appropriate fee amount (fee includes en-suite accommodation and full tuition costs) Early Registration (before 1.2.12) 2,095 Standard Registration
2,310
1990.25
Yes
No
If you have ticked yes, please disclose details of the offence and conviction separately.
Declaration
By submitting an application form you are agreeing to pay any deposits by 30 April and the full fees by the balance due date 31 May 2012. Once a deposit is received by the University of East Anglia it is non-refundable, even if you decide not to attend the programme. The University of East Anglia reserves the right to cancel or amend the International Summer School programme for reasons of viability or due to any other unforeseen circumstances. Our full terms and conditions can be found on our webpages on the Fees page.
I Agree
Signed
Web: www.uea.ac.uk/summerstudyabroad
We aim to process applications within 2 weeks of receipt and will respond to all applicants to advise outcome, with deadline for payment of deposit, total fee due and balance due date.