Immigration Form

Your Certificate of Sponsorship reference number (e.g. C3J8J95066D. Do not enter your sponsor ID or sponsor reference number)

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First Name

Last Name

Address

Address Line 1

Address Line 2

Postcode

Any Other Names

In addition to the names already provided, are you now or have you ever been known by another name?

You must provide all your names. For example, if you change your name after marriage or have a different name that you use for professional purposes.

Your Sex

Male

Female

Unspecified

What is your relationship status?

Single

Married or Civil Partners

Unmarried Partner

Divorced or civil Partner dissolved

Separated

Widowed or surviving civil partner

Your Address

How long have you lived at this address?

What is the ownership status of your home?

I own it

I rent it

Other

National identity card number if you have one (this includes identity cards, issued from non-UK governments. This does not include driving licenses. If you have an internal passport, provide the details here.

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Country of birth

Place of birth (city)

Do you currently hold, or have you ever held, any other nationality or citizenship?

Country of other nationality

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Date held from

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Date held to

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Do you still hold this nationality?

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Your Immigration Status

What permission do you have to be in the country you are resident in?

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I have a temporary visa

I am a permanent resident

I do not have a visa and I am not a permanent resident

If you have a temporary visa, confirm when it is valid until

If you are a permanent resident, which year did you become a permanent resident?

If you are do not have a temporary visa and are not a permanent resident, give as much information about your status as possible, including if:

You are waiting for a decision on a base
You are not required to have a visa to be in the country
You are not in the country legally

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Spoken Language Preference

Have you provided evidence of your English language ability in a previous application?

You must have been granted a visa or permission to stay after meeting the language requirement at level B1 or above. For example:

Scored level B1, B2, C1 or C2 on an approved English language test which assessed your reading, writing, speaking, and listening skills.

Yes

Have a degree which was taught in English

Yes

Have an English language or literature GCSE, an international GCSE, an A level, or a Scottish National 4 or 5, higher, or Advanced Higher qualification

Yes

If you were a student, your sponsor confirmed on your CAS that you met the required level.

Yes

Do you have a PhD which is relevant to your job in the UK (check your Certificate of Sponsorship (COS) or ask your sponsor? If yes, do you have an Ecctis reference number for your PhD?

Provide your Ecctis reference number

If you do not have an Ecctis reference number, you will need to provide a copy of your full PhD certificate.

English Qualification from a UK School (English language or literature qualification)

Yes

Do you have a degree equivalent to a bachelor’s degree which was taught in English?

Yes

If you have a research degree, your research must have be done in English.

Yes

Country your degree was taught in

English Language Test

Have you passed an approved English language test in the last 2 years?

Yes

The test must have include reading, writing, speaking and listening skills.

Yes

You must have scored level B1, B2, C1 or C2.

Yes

Awarding body

For example IELTS SELT Consortium

Your reference number

Your Current Partner

Given Name

Family Name

Date of Birth

Country of nationality

Do they currently live with you?

Yes

Will they be traveling with you to UK?

Yes

Do they currently live with you

Yes

Their address

Give Details About Your First Parent

What is this person’s relationship to you?

Mother

Father

Given Name

Family Name

Date of Birth

Country of nationality

Have they always had the same nationality?

Yes

Their country of nationality when you were born

Give Details About Your Second Parent

What is this person’s relationship to you?

Mother

Father

Given Name

Family Name

Date of Birth

Country of nationality

Have they always had the same nationality?

Yes

Their country of nationality when you were born

Do have any family in UK?

This includes:

Immediate family- such as spouse, civil partner, parents, children, brothers or sisters
Grandparents or grandchildren
Your spouse or civil partner's family
Your child spouse, civil partner or partner
Your partner, if you have lived with them for 2 out of last three years

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Yes

About Your Relative

Their relationship to you

Given Name

Family Name

Country of nationality

What permission do they have to be in UK?

They have a temporary visa

They are in UK permanently

They do not have a visa and are not in UK permanently

I cannot contact my relative

If they have a temporary visa or in the UK permanently, provide their passport number

If they do not have a visa and are not in UK permanently, for example they are waiting for a decision on visa

Please provide the address where you will be staying in the UK

If you do not know the address where you will be staying, give as much detail as possible of where you intend to stay, for example in a hotel, private housing, or with friends. Please also include dates.

UK Travel History

Have you been to the UK in past 10 years?

Yes

How many times have you been to UK in past 10 years? If you are unsure of exact number, provide an estimation. You will be asked to provide details for up to 3 of your most recent times in the UK.

Please provide details:

Date you arrived in the UK

Reason (for example, tourism, work, study, transit)

How long were you in the UK

Have you ever been given medical treatment in UK? For example, if you visited a doctor, clinic or hospital, this counts as having medical treatment

Yes

Were you told that you had to pay the hospital, clinic or doctor's surgery bb for your medical treatment? This does not include the immigration health surcharge.

Yes

Have you paid the full amount?

Yes

If you have not paid the full amount, please provide detail of previous medical treatment in the UK

Names of hospital, clinic or doctor’s surgery

Address

When did you start receiving this medical treatment?

When did you stop receiving this medical treatment?

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I am still receiving this medical treatment

UK Leave To Remain

Have you applied to remain in the UK in the past 10 years?

Yes

Date of application

What was result of your application

Approved

Refused

Do you have a National insurance number? (this will be on your national insurance card, benefit letter, payslip or P60)

Do you have a UK driving license? Enter your license number

Public Funds

Have you received any public funds (money) in the UK?

This includes benefits for people on low income, housing or child benefit. If you are applying from inside the UK, you only need to tell us about the public funds you have received since you were last granted permission

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Yes

Name of the public fund

Frequency of payment

Weekly

Monthly

Public fund amount per payment £

When did you start receiving this public fund?

When did you stop receiving this public fund?

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I still receive this public fund

Travel To Australia, Canada, New Zealand, USA, Switzerland Or European Economic Area

Have many times have you visited the following places in past 10 years?

Australia
Canada
New Zealand
USA
Switzerland
European Economic Area (do not include travel to UK)

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Zero

Once

2 to 5 times

6 or more times

If you have visited the above countries, then provide details of your most recent travel. Which country did you visit and what was the reason for your visit? What was the date of your visit and how long was your visit?

Have you been to any other countries in past 10 years? Do not include visit to UK, Australia, Canada, New Zealand, USA, Switzerland or European Economic Area

Yes

If you have visited another country, then provide details of your most travels. Which countries did you visit and what was the reason for your visit? What was the date of your visit and when did your visit end?

Date you plan to arrive in UK

Immigration History

For either the UK or any other country, have you ever been:

Refused visa
Refused entry at the border
Refused permission to stay or remain
Refused asylum
Deported
Removed
Required to leave
Excluded or banned from entry

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Yes

If yes, give more details of what happened, including when the immigration problem happened.

Have you ever:

Entered the UK illegally
Remained in the UK beyond the validity of your visa or permission to stay
Breached the conditions of your leave, for example, worked without permission or received public funds when you did not have permission
Given the false information when applying for visa , leave to enter or leave to remain
Breached UK immigration law in any other way

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Yes

Give details of what happened including when the breach happened (month and year)

At any time have you ever had any of the following, in the UK or in another country?

A criminal conviction

A penalty for driving offense, for example disqualification for speeding or no motor insurance

An arrest or charge for which you are currently on, or awaiting trials

A caution, warning, reprimand or other out-of-court penalty

A civil court judgment against you, for example for non-payment of debt, bankruptcy proceedings or antisocial behaviour

A civil penalty issued under UK immigration law

No, I have never had any of these

Please provide detailed information including dates.

In either peace or war time have you ever been involved in, or suspected of involvement in, war crimes, crimes against humanity, or genocide?

Yes

Have you ever been involved in, supported or encouraged terrorist activities in any country?

Yes

Have you ever been a member of, or given support to, an organization which has been concerned in terrorism?

Yes

Have you, by any means and medium, expressed views that justify or glorify terrorist violence or that may encourage others that commit terrorist or other serious criminal acts?

Yes

Have you ever been a member of, or given support to, an organization which has been concerned in extremism?

Yes

Have you, by any means and medium, expressed extremist views?

Yes

Have you, as part of your employment or otherwise, undertaken paid or unpaid activity on behalf of non-UK government which you know to be dangerous to the interest or national security if UK or its allies?

Yes

Have you ever engaged in any other activities which might indicate that you may not be considered to be a person of good character?

Yes

Your Employment History

have you ever worked for any of the following types of organization? Include information for any paid or unpaid work. Select all that apply.

Armed forces (career)

Armed forces (compulsory National or military service)

Government (including public or civil administration and non-military compulsory National service)

Intelligence services

Security organizations (including police and private security services)

Media organizations

Judiciary (including work as a judge or magistrate)

I have not worked in any jobs listed above

Sponsor License Number

What is your sponsor license number as shown on your certificate of sponsorship?

Your sponsor is an organization you will be working for in UK, who are sponsoring this application.

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