Assessment Form

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Personal Information

Fullname

contact number

Email Address

Educational Background

Highest level

Course title

Area of interest

Country of Interest

Course Level

Subject of choice 1

Subject of choice 2

Other (Please specify)

English Background

English exam taken

Other (Please specify)

Date English exam was undertaken

Immigration Background

Have you ever been granted a student visa to any country?

Yes No

Have you ever had a visa refused to Enter any country?

Yes No

Have you ever been deported from any country?

Yes No

Do you have any criminal convictions in any country?

Yes No

If yes to any of the above questions, please give details

Financial Matters

Who will pay for your course tuition fees and upkeep while studying?

How did you find out about Study Connect?

I confirm that, to the best of my knowledge, the information given is correct and complete. I agree that Study Connect can process my information for my application and internal research.

Yes

Assessment Form

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