Fee Assessment Form – Complete all sections unless stated

Fee status is assessed on the basis of the available information provided with your application to study at the
University of York. If you consider your fee status to be incorrect please complete this form in full.

The personal information you provide in this form will be used to determine whether the University of York will assign
you a fee status of Home (UK and some eligible EU/EEA/Swiss students) or Overseas (including EU/EEA/Swiss).

Where indicated you must provide the supporting documents. If you do not do this we may need to request additional
information, which will delay the confirmation of your fee status.

Please read the UKCISA fee guidance before completing this form.
Please refer to our Privacy notice for student applicants for further details on how we manage your data.

SECTION 1: PERSONAL DETAILS

Title:
First/Given names:
Surname:
Date of birth
(DD/MM/YYYY)
Applicant/UCAS ID:
Student number (if
known):
Course title:
Course start date:

SECTION 2: E LIGIBILITY C ATEGORY

The UK Council for International Student Affairs (UKCISA) provides guidance on eligibility requirements for home fee
status. Please read the UKCISA fee guidance and confirm which category you feel accurately describes your
circumstances.

I consider myself to be eligible for home fees under

category:

If none of the categories are relevant to your

circumstances, please tick this box

SECTION 3: I MMIGRATION S TATUS

Please indicate below, all that apply

British Citizen

EU/EEA/Swiss with Settled Status or Pre-settled Status in

the UK

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EEA/Swiss migrant worker in the UK

In the UK on Visa (including resettlement schemes), or the If yes, expiry date of

child/spouse of someone holding a Visa Visa (DD/MM/YYYY):
If yes, date status
Granted Indefinite Leave to Remain in the UK granted
(DD/MM/YYYY):
If yes, date status
Granted Exceptional Leave to Remain in the UK, or the
granted
child/spouse of someone with Exceptional Leave to Remain
(DD/MM/YYYY):
If yes, date status
Refugee, or the child/spouse of a refugee granted
(DD/MM/YYYY):
Relevant Family member of a UK/EU/EEA/Swiss National.
Please give details in Section 4

Other not specified above. Please give details:

Please include copies of all relevant documentation you hold that supports your status

SECTION 4: RELEVANT FAMILY MEMBERS

O nly complete this section if you have identified that you are a relevant family member of the UK/EU/EEA/Swiss
National in section 3
Please include official documentation which legally confirms your relationship i.e . birth or marriage certificate
Name of Relative
Relationship to you Nationality of Relative
Name of Relative
Relationship to you Nationality of Relative
Name of Relative
Relationship to you Nationality of Relative

S ECTION 5: RESIDENTIAL H ISTORY

Please provide dates and locations where you have been resident for the last 3 years, ensuring that there are no gaps
over this period. Note if you have lived in a country other than the UK prior to this, add details here also.
Please include supporting documents

Date from (DD/MM/YYYY): Date to (DD/MM/YYYY):

Reason for residence (eg education, employment):

Address:

Date from (DD/MM/YYYY): Date to (DD/MM/YYYY):

Reason for residence (eg education, employment):

Address:

Date from (DD/MM/YYYY): Date to (DD/MM/YYYY):

Reason for residence (eg education, employment):

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Address:

Date from (DD/MM/YYYY): Date to (DD/MM/YYYY):

Reason for residence (eg education, employment):

Address:

Date from (DD/MM/YYYY): Date to (DD/MM/YYYY):

Reason for residence (eg education, employment):

Address:

Date from (DD/MM/YYYY): Date to (DD/MM/YYYY):

Reason for residence (eg education, employment):

Address:

Section 5: Residential History - continued

If you are completing this form after the start of your course and your course started between:

● 1 August and 31 December, please provide your address for where you were living on the 1st September.
● 1 January and 31 March, please provide your address for where you were living on the 1st Janua ry.
● 1 April and 30 June, please provide your address for where you were living on the 1st April.
● 1 July and 31 July, please provide your address for where you were living on the 1st July.

Date from (DD/MM/YYYY): Date to (DD/MM/YYYY):

Reason for residence (eg education, employment):

Address:

S ECTION 6: UK/EEA NATIONALS LIVING OVERSEAS

ONLY complete this section if you are a national of the UK, Iceland, Liechtenstein, Norway, Switzerland or have
Settled Status in the UK, and have been living outside the UK/EEA in the last 3 years

Please provide full details of all return visits. You must include documents showing these return visits (eg flight
bookings, entry/exit passport stamps).
Date visit began Date visit ended Reason for visit (eg Where and with whom you
Length of visit
(DD/MM/YYYY) (DD/MM/YYYY) holiday, education) stayed

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Please provide information below if you or your parents have maintained a home in the UK/EEA during any periods of
absence over the last 3 years (please include dates, address, ownership details and supporting evidence) .

SECTION 7: TEMPORARY A BSENCE

ONLY complete this section if you have been ordinarily resident in the UK/ EEA during the last 3 years except for the
fact that you/ your spouse/ your parent(s) were temporarily employed or in education abroad. Please give details
including the length of time spent abroad and the nature of the work/education.
Please also provide us with a copy of your/your spouse/your parent(s) employee contract and/or temporary residence
visa, alongside this questionnaire.

Who was temporarily

employed/in education?
When did you leave the UK/EEA for this
employment/education (DD/MM/YYYY)?
When did you/intend to return (DD/MM/YYYY)?
In which country is/was the temporary
employment/education undertaken?
If it were not for the employment/education outside the
area described above, in which country would you be living?

SECTION 8: ADDITIONAL INFORMATION

P LEASE PROVIDE ANY OTHER RELEVANT INFORMATION FOR ASSESSING YOUR FEE STATUS

SECTION 9: DECLARATION

By signing and submitting this form, I confirm that the information given on this form is true, complete and accurate.
The information you supply in this form will be used to determine your status for fee paying purposes at the
University of York or the Hull York Medical School (HYMS) in accordance with the Uni versity of York’s data protection
policies. Information on this is available from Records Management & Information Governance .

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The decision of the University of York does not entitle you to t he same fee status at another institution, nor does a
ruling at another institution have a bearing on your fee status at the University of York.
Should the University of York establish at any time that the information provided is incorrect/false, it reser ves the
right to withdraw its offer of a place, terminate your attendance or amend the tuition fee status before or after
enrolment.
Signature of applicant/student (if you are
completing the form electronically, you may type
your name if you wish):
Date (DD/MM/YYYY):

It might not be possible to make an assessment on your fee status without contacting the UK Visas and Immigration
(UKVI) for further information. Please confirm that you give permission for the University of York to contact UKVI by
ticking this box. Please note that if you do not confirm we may not be able to complete the fee assessment.

Please provide copies of the following documents to support your assessment.

● Immigration documents (e.g. passport, visa, Indefinite Leave to Remain)
● Documents including your name, parent /legal guardian, your address (e.g. bank statement, utility bill, Council
Tax bill) that confirm your ordinary residence over the three years before the first day of the academic year in
which your course starts (please note we only require ONE document per year of residency).
If you have completed SECTION 4, please ensure you provide:
● Evidence of your relationship to the relatives you have provided
If you have completed SECTION 5, please ensure you provide:
● Evidence of your relationship to the relatives you have provided
If you have completed SECTION 6, please ensure you provide:
● Evidence of your return visits (e.g. flight bookings, entry/exit passport stamps)
If you have completed SECTION 7 on temporary employment abroad, please ensure you provide:
● Evidence of temporary employment or education (e.g. copies of temporary contract(s) from the employer(s))

Please ensure that you complete, save and email this form, with electronic copies of all the documents we have
requested, to:

New applicants please email:

Undergraduate Admissions – [email protected]
Postgraduate Admissions - [email protected]
Online or Distance Learners – [email protected]

For enrolled, new or continuing students please email: [email protected]

Please note we cannot make a decision without all the supporting documents we have requested.

If you are unable to email your form, please post a paper copy to:

For applicants:
Undergraduate Admissions / Postgraduate Admissions
University of York
York
YO10 5DD

For enrolled, new or continuing students:

Student Records, Student Services
Student Admin Building
Vanbrugh Walkway
5
University of York
YO10 5DD

Please do not send original documents unless requested.

For administrative use only

Fee assessment decision:

Name:
Signature:
Date (DD/MM/YYYY):