GW F 037146840

Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE
APPLICANT BIOGRAPHIC DETAILS AND TRAVEL DATE
APPLICATION ID: GWF037146840
GIVEN NAMES: THIERRY CLAUDIEN
FAMILY NAME: UHAWENIMANA
DATE OF BIRTH: 26 MAR 1981
PLACE OF BIRTH: RUSIGA, RULINDO
SEX: MALE
NATIONALITY: RWANDA
PASSPORT NUMBER: PC 169321
VISA APPLICATION NUMBER:
GWF037146840
DATE APPLICATION 07 AUG 2015
SUBMITTED ONLINE:
DATE OF PLANNED ARRIVAL 07 SEP 2015

IN THE UK:
VISA APPLICANT CONTACT DETAILS
APPLICANTS EMAIL tcuhawenimana@gmail.com

ADDRESS:
APPLICANTS PRIMARY 250788586768

NUMBER:
APPLICANTS SECONDARY 250722958316

NUMBER:
>> OFFICIAL USE ONLY
VISA APPLICATION FEE AND PAYMENT CONFIRMATION
PAYMENT REFERENCE: 4060272443
USER PAY FEE: USD 94.40
TOTAL FEE: USD 610.00
PAYMENT MADE: YES - ONLINE
PAYMENT DATE: 07 AUG 2015
VISA APPLICATION SUBMISSION
SUBMISSION METHOD: STANDARD
>>OFFICE USE ONLY
CATEGORY: PBS TIER 4 STUDENT
TYPE: TIER 4 (GENERAL) STUDENT
EC NUMBER:
Created: 07/08/2015 Page 1 CODE

DECLARATION
I declare that the information given on this form whether input by myself, input on my behalf by a third party or automatically pre-populated is complete
and correct to the best of my knowledge and belief. I also declare that the photograph submitted with this form is a true likeness of me. I confirm that if,
before this application is decided, there is a material change in my circumstances or new information relevant to this application becomes available, I
will inform the United Kingdom diplomatic mission handling my application.
I understand that all information provided by me will be processed by the Home Office in accordance with the Data Protection Act 1998. I am aware
that the Home Office is the data controller in relation to the information provided by me in this application form. I am aware that the information I
provide, including biometric data, will be treated in confidence, but it may be disclosed to other government departments, agencies, local authorities,
foreign governments, and other bodies, to enable the Home Office or those bodies to perform their functions. Any disclosures will be in accordance with
the Data Protection Act 1998. I also understand that the information provided by me may also be used for staff training purposes.
I declare that the documents that I have supplied with this application are genuine and the statements I have made with this application are truthful. I
understand that the Home Office (or a trusted third party) may make reasonable checks to confirm the accuracy and authenticity of evidence I have
provided and documents I have submitted with this application. I further understand that the Home Office (or a trusted third party) may also make
reasonable checks on any sponsors to my application to verify statements contained in the application and establish that I will comply or have complied
with the terms of any visa granted.
I understand that UK entry clearance applications may be handled by British Missions in other locations, including outside the country in which I have
applied for entry clearance and that this may involve the transferring of my application and supporting documents to and from another Mission. I
understand that the Home Office will be responsible for transferring my application and supporting documents safely. I understand in these
circumstances my application will still be handled in line with Home Office published customer service standards.
I understand that the fee payable is for an application processing and entry clearance decision-making service, not for the guaranteed delivery of a
visa, therefore I will not be entitled to a refund should my application for entry to the UK or Commonwealth and Overseas Territories be refused or
granted for a shorter time period than I applied for. I also understand that my visa application fee will be refunded only if the application is withdrawn in
writing within 3 months and 7 days of the original date of application and prior to the submission of biometric data or any processing taking place.
I also understand that the information provided by me, or information made available to the Home Office during the processing of my application, may
be shared with my sponsor(s) or any person(s) acting on their behalf or any applicant linked to my application (for example to my spouse / partner if we
apply for visas for a trip together) for the sole purpose of considering my application.
I am aware that if there is any information I do not want you to disclose to them I will tell you by enclosing a letter with my supporting documentation. If
such requests prevent you from making legitimate inquiries, my application may be refused.
I am also aware that my application will be automatically refused and I may be banned from going to the UK for 10 years if I use a false document, lie or
withhold relevant information. I may also be banned if I have breached immigration laws in the UK. I am further aware that should I use a false
document, lie or withhold relevant information my details may be passed to law enforcement agencies.
I understand that I may be required to provide a record of my fingerprints and a photograph of my face (“biometric data”) as part of my application. If I
refuse to do so, my application may be treated as invalid and, if so, will not be considered further. (See Statutory Instrument 2006 No 1743 - The
Immigration (Provision of Physical Data) Regulations 2006, Regulation 7(1)).
I understand that providing biometric information as part of an application is confirmation of consent to having biometric information checked at the UK
border to verify identity. Where I am applying for entry to the UK, I accept that the payment of an Immigration Health Surcharge may be required. I
understand that separate rules governing whether the Surcharge is applicable and when a refund would be due are available via the visas and
immigration pages of the gov.uk website.
I am aware that I may be billed for any NHS medical treatment undertaken in the UK and that I do not have recourse to public funds during my stay in
the UK. I understand that if I fail to pay NHS debts incurred by me this could adversely affect future entry clearance applications I make.
I understand that my details may, in certain circumstances, be passed to fraud prevention agencies to prevent and detect fraud and money laundering.
I also understand that such agencies may provide the Home Office with information about me. Further details explaining when information may be
passed to or from fraud prevention agencies and how that information may be used can be obtained from the Home Office website.
I am aware that it is an offence under the Immigration Act 1971 (as amended) to make a statement which I know to be false, or not believe to be true, in
order to obtain a visa/entry clearance to the UK.
I hereby apply for a transfer of a visa/entry clearance to the United Kingdom.
APPLICANT'S SIGNATURE:
DATE SIGNED:
FORM COMPLETED BY: THIERRY CLAUDIEN UHAWENIMANA
GWF037146840

APPLICANT NAME: Thierry Claudien UHAWENIMANA

APPLICATION NUMBER: GWF037146840
DATE OF APPLICATION: 07/08/2015
TYPE OF VISA: PBS Tier 4 Student
PURPOSE OF APPLICATION: Study
TYPE OF APPLICATION: Tier 4 (General) Student
USER PAY FEE: USD 94.40
TOTAL FEE: USD 610.00
SUBMISSION METHOD: Standard
ISSUING OFFICE: British Embassy Kigali - Kigali
PAYMENT MADE: YES - ONLINE
FORM: Tier 4 (General) Student
PART 1 > PASSPORT AND TRAVEL INFORMATION

PASSPORT / TRAVEL DOCUMENT
1 FAMILY NAME / SURNAME UHAWENIMANA
(IF YOU ONLY HAVE ONE NAME, PLEASE ENTER IT HERE
AND IN THE GIVEN NAME BOX)
2 GIVEN NAME(S) / FORENAME(S) THIERRY CLAUDIEN
AND IN THE FAMILY NAME BOX)
3 DATE OF BIRTH 26 MAR 1981
4 PLACE OF BIRTH RUSIGA, RULINDO
5 GENDER MALE
6 NATIONALITY RWANDA
7 DO YOU CURRENTLY HOLD, OR HAVE YOU EVER HELD, NO
ANY OTHER NATIONALITY OR NATIONALITIES?
8 CURRENT PASSPORT OR TRAVEL DOCUMENT NUMBER PC 169321
9 PLACE OF ISSUE KIGALI
10 ISSUING AUTHORITY RWANDA IMMIGRATION
11 DATE OF ISSUE 07 JAN 2013
12 DATE OF EXPIRY 07 JAN 2018
13 COUNTRY OF RESIDENCE RWANDA
14 ARE YOU A NATIONAL OF THE COUNTRY IN WHICH YOU YES
ARE APPLYING?
15 IS THIS YOUR FIRST PASSPORT? NO
DOCUMENT NUMBER PC 063916
ISSUING AUTHORITY IMMIGRATION SERVICES
DATE OF ISSUE 24 DEC 2007
DATE OF EXPIRY 24 DEC 2012
IS THIS DOCUMENT LOST, STOLEN OR IN YOUR POSSESSION IN YOUR POSSESSION
TRAVEL INFORMATION
17 ARE YOU TRAVELLING WITH ANYONE? NO
18 DATE OF PLANNED ARRIVAL IN THE UK 07 SEP 2015

19 HOW LONG DO YOU INTEND TO STAY IN THE UK? FOUR YEARS

20 WHAT IS THE MAIN ADDRESS AND CONTACT DETAILS NAME OF PERSON / HOTEL: PROF. GERDA SIANN
OF WHERE YOU WILL BE STAYING WHILST IN THE UK? LINE 1: 11 ROSSLYN CRESCENT
LINE 2: EDINBURGH
POST CODE: EH6 5AT
PRIMARY CONTACT NUMBER: 0131 5544919
SECONDARY CONTACT NUMBER: 07791798061
EMAIL: GERDASIANN@YAHOO.CO.UK
PART 2 > PERSONAL DETAILS AND TRAVEL HISTORY

PERSONAL DETAILS
21 WHAT IS YOUR PERMANENT RESIDENTIAL ADDRESS LINE 1: NYARUGENGE DISTRICT
AND CONTACT DETAILS? LINE 2: KIGALI
POST CODE: RW
COUNTRY: RWANDA
PRIMARY CONTACT NUMBER: 250788586768
SECONDARY CONTACT NUMBER: 250722958316
EMAIL: TCUHAWENIMANA@GMAIL.COM
22 HOW LONG HAVE YOU LIVED AT THIS ADDRESS? 9 YEARS
23 ARE YOUR PREFERRED CONTACT DETAILS DIFFERENT NO
FROM THE CONTACT DETAILS ALREADY PROVIDED
ABOVE?
TRAVEL HISTORY
24 HAVE YOU BEEN ISSUED ANY VISA FOR THE UK, UK YES
OVERSEAS TERRITORIES OR COMMONWEALTH
COUNTRY IN THE LAST 10 YEARS?
25 TYPE OF VISA ISSUED TOURIST VISA
DATE OF ISSUE 22 OCT 2010
DATE OF EXPIRY 22 DEC 2010
ISSUING AUTHORITY AUSTRALIA HIGH HC
TYPE OF VISA ISSUED VISITORS VISA
DATE OF ISSUE 03 FEB 2011
DATE OF EXPIRY 03 MAY 2011
ISSUING AUTHORITY SWAZILAND HC
26 HAVE YOU EVER TRAVELLED TO THE UK IN THE LAST 10 NO

YEARS?
27 HAVE YOU MADE AN APPLICATION TO THE HOME NO
OFFICE TO REMAIN IN THE UK IN THE LAST 10 YEARS?
28 HAVE YOU BEEN REFUSED ENTRY TO THE UK IN THE NO
LAST 10 YEARS
(FOR EXAMPLE AT A UK AIRPORT OR SEAPORT)?
29 HAVE YOU BEEN REFUSED A VISA FOR ANY COUNTRY NO
INCLUDING THE UK IN THE LAST 10 YEARS?
30 HAVE YOU BEEN DEPORTED, REMOVED OR OTHERWISE NO
REQUIRED TO LEAVE ANY COUNTRY INCLUDING THE UK
IN THE LAST 10 YEARS?

31 HAVE YOU EVER VOLUNTARILY ELECTED TO DEPART NO

THE UK?
32 ARE YOU, OR HAVE YOU BEEN SUBJECT TO, AN NO
EXCLUSION ORDER FROM THE UK?
33 HAVE YOU EVER TRAVELLED OUTSIDE YOUR COUNTRY YES
OF RESIDENCE, EXCLUDING THE UK, IN THE LAST 10
YEARS?
34 DATE OF TRAVEL 20 NOV 2010
COUNTRY VISITED AUSTRALIA
REASON FOR THE TRIP ATTENDING A CONFERENCE
DATE OF TRAVEL 31 JAN 2011
COUNTRY VISITED SWAZILAND
REASON FOR THE TRIP ATTENDING A CONFERENCE
DATE OF TRAVEL 01 FEB 2012
COUNTRY VISITED UGANDA
REASON FOR THE TRIP STUDIES UNTIL JULY 2014
35 DO YOU HAVE A UK NATIONAL INSURANCE NUMBER? NO

36 DO YOU HAVE ANY CRIMINAL CONVICTIONS IN ANY NO
COUNTRY
(INCLUDING SPENT/UNSPENT CONVICTIONS AND
TRAFFIC OFFENCES)?
37 HAVE YOU EVER BEEN CHARGED IN ANY COUNTRY NO
WITH A CRIMINAL OFFENCE FOR WHICH YOU HAVE NOT
YET BEEN TRIED IN THE COURT (INCLUDING TRAFFIC
OFFENCES)?
38 HAVE YOU EVER BEEN INVOLVED IN, SUPPORTED OR NO
ENCOURAGED TERRORIST ACTIVITIES IN ANY
COUNTRY? HAVE YOU EVER BEEN A MEMBER OF, OR
GIVEN SUPPORT TO, AN ORGANISATION THAT HAS
BEEN CONNECTED WITH TERRORISM?
39 HAVE YOU EVER, BY ANY MEANS OR MEDIUM, NO
EXPRESSED VIEWS THAT JUSTIFY OR GLORIFY
TERRORIST VIOLENCE, OR THAT MAY ENCOURAGE
OTHERS TO COMMIT ACTS OF TERRORISM OR OTHER
SERIOUS CRIMINAL ACTS?
40 IN TIMES OF EITHER PEACE OR WAR HAVE YOU EVER NO
BEEN INVOLVED IN, OR SUSPECTED OF INVOLVEMENT
IN, WAR CRIMES, CRIMES AGAINST HUMANITY OR
GENOCIDE?
41 HAVE YOU ENGAGED IN ANY OTHER ACTIVITIES THAT NO
MIGHT INDICATE THAT YOU MAY NOT BE ADMITTED TO
THE UK?
42 IF WE NEED TO INTERVIEW YOU, WHAT LANGUAGE ENGLISH
WOULD YOU LIKE TO USE IN THE INTERVIEW?
PART 3 > FAMILY DETAILS

SPOUSE / PARTNER

43 WHAT IS YOUR MARITAL STATUS? MARRIED / CIVIL PARTNER

44 WILL YOUR SPOUSE/PARTNER BE TRAVELLING WITH NO
YOU?
45 CURRENT PASSPORT OR TRAVEL DOCUMENT NUMBER N/A
47 FAMILY NAME / SURNAME MUKABALISA
AND IN THE GIVEN NAME BOX)
48 GIVEN NAME(S) / FORENAME(S) JANET
(IF THEY ONLY HAVE ONE NAME, PLEASE ENTER IT
HERE AND IN THE FAMILY NAME BOX)
49 DATE OF BIRTH 18 AUG 1980
50 DOES YOUR SPOUSE / PARTNER CURRENTLY LIVE WITH YES
YOU?
FATHER
52 FAMILY NAME / SURNAME HAKIZIMFURA
HERE AND IN THE GIVEN NAME BOX)
53 GIVEN NAME(S) / FORENAME(S) SERVELIEN
54 DATE OF BIRTH 01 JAN 1952
MOTHER
57 FAMILY NAME / SURNAME SINGIRANUMWE
HERE AND IN THE GIVEN NAME BOX)
58 GIVEN NAME(S) / FORENAME(S) BELANCILLE
59 DATE OF BIRTH 01 JAN 1957
DEPENDENT CHILDREN
61 DO YOU HAVE ANY DEPENDENT CHILDREN? YES

PASSPORT NUMBER N/A
NATIONALITY RWANDA
FAMILY NAME GISUBIZO
GIVEN NAMES TIAMO ARIELLA
DATE OF BIRTH 23 APR 2011
PLACE OF BIRTH KIGALI, RWANDA
TRAVELLING WITH YOU NO
LIVE WITH YOU YES
ADDRESS 1 NYARUGENGE, KIGALI
ADDRESS 2
ADDRESS 3
ADDRESS 4
POSTAL CODE
COUNTRY RWANDA
CONTACT NUMBER 250788586768
PASSPORT NUMBER N/A
NATIONALITY RWANDA
FAMILY NAME INEZA
GIVEN NAMES TRACY DANIELLA
DATE OF BIRTH 16 APR 2015
PLACE OF BIRTH KIGALI,RWANDA
TRAVELLING WITH YOU NO
LIVE WITH YOU YES
ADDRESS 1 NYARUGENGE, KIGALI
ADDRESS 2
ADDRESS 3
ADDRESS 4
POSTAL CODE
COUNTRY RWANDA
CONTACT NUMBER 250788586768
NON DEPENDENT CHILDREN

62 ARE ANY OTHER CHILDREN TRAVELLING WITH YOU? NO
PART 4 > MEDICAL TREATMENT

MEDICAL TREATMENT
63 HAVE YOU EVER RECEIVED MEDICAL TREATMENT IN NO
THE UK?
PART 5 > TIER 4 STUDENT

SPONSOR
64 GIVE YOUR TIER 4 SPONSOR'S LICENCE NUMBER WYUXKW7Y7
65 WHAT IS THE NAME OF YOUR SPONSOR? MRS GILLIAN SHARP

66 WHAT IS THE FULL ADDRESS OF YOUR SPONSOR? ORGANISATION: UNIVERSITY OF DUNDEE

LINE 1: PERTH ROAD
LINE 2: DUNDEE
POST CODE: DD1 4HN
PRIMARY CONTACT NUMBER: 4401382385659
EMAIL: G.G.SHARP@DUNDEE.AC.UK
STUDIES
67 WHAT IS YOUR CONFIRMATION OF ACCEPTANCE FOR E4G5MB2E29T014
STUDIES NUMBER?
68 WHAT IS THE TITLE OF YOUR COURSE? PHD INTEGRATED NURSING AND MIDWIFERY
69 WHAT IS THE LEVEL OF THE COURSE AND SCQF12
QUALIFICATION?
70 START DATE OF COURSE 07 SEP 2015
71 END DATE OF COURSE 06 SEP 2019
72 HAVE YOU ALREADY STARTED STUDYING THIS NO
COURSE?
73 WHAT IS THE ADDRESS OF THE MAIN SITE OF STUDY? ORGANISATION: UNIVERSITY OF DUNDEE
LINE 1: 11 AIRLIE PLACE
LINE 2: DUNDEE
POST CODE: DD1 4HJ
PRIMARY CONTACT NUMBER: 44 1382 388534
EMAIL: M.C.SMITH@DUNDEE.AC.UK
74 CONFIRM WHICH OF THE FOLLOWING OPTIONS APPLY UNDERTAKING A FOUNDATION PROGRAMME AS A
POSTGRADUATE DOCTOR OR DENTIST
75 PLEASE INDICATE HOW YOU MEET THE MINIMUM YOUR SPONSOR IS A HIGHER EDUCATION INSTITUTION
ENGLISH LANGUAGE REQUIREMENT RELEVANT TO (HEI), AND HAS MADE ITS OWN ASSESSMENT OF YOUR
YOUR COURSE ENGLISH LAGUAGE ABILITY
76 ARE YOU REQUIRED TO OBTAIN PERMISSION FROM NO
THE ACADEMIC TECHNOLOGY APPROVAL SCHEME
(ATAS)?
MAINTENANCE AND FEES

77 HOW MUCH ARE THE FEES FOR YOUR COURSE OF 10,000 GBP
STUDY?
78 HAVE ANY OF YOUR COURSE FEES BEEN PAID? YES - PAID TO UK EDUCATION PROVIDER
79 PLEASE ENTER THE AMOUNT GBP(£) 10,000 GBP
80 WHAT DOCUMENT HAS BEEN PROVIDED AS EVIDENCE SHOWN IN THE CAS
OF PAYMENT
81 DO YOU HAVE AN ESTABLISHED PRESENCE IN THE UK? NO
82 FOR THIS INITIAL APPLICATION WHAT IS YOUR YOUR OUTSIDE THE INNER LONDON BOROUGHS
PRIMARY SITE OF STUDY?
83 HOW MUCH FUNDING GBP(£) PER MONTH DO YOU HAVE 400 GBP
TO COVER YOUR THE MAINTENANCE CHARGES?
84 HAVE ANY OF YOUR ACCOMMODATION FEES BEEN NO
PAID TO YOUR SPONSOR?
85 DO YOU RECEIVE SUPPORT FROM A FINANCIAL YES
SPONSOR THAT MEETS THE UK VISA AND IMMIGRATION
DEFINITION OF A FINANCIAL SPONSOR?

86 WHAT IS THE NAME OF THE OFFICIAL FINANCIAL RWANDA EDUCATION BOARD

SPONSOR?
87 HOW MUCH IN GBP(£) IS THE OFFICIAL FINANCIAL 900 GBP
SPONSOR OR GOVERNMENT SPONSOR PAYING
TOWARDS YOUR EXPENSES?
88 COURSE FEES 10,000 GBP PER ACADEMIC YEAR
89 MAINTENANCE FEES
90 DO YOU HAVE ANY REMAINING FEES AND NO
MAINTENANCE STILL DUE FOR PAYMENT?
91 DO YOU HAVE MONEY IN YOUR OWN NAME? NO
92 WHAT EVIDENCE HAVE YOU PROVIDED THAT SHOWS FINANCIAL GUARANTEE GIVEN BY THE RWANDA
BOTH THE AMOUNT OF FUNDS AVAILABLE AND YOUR EDUCATION BOARD
RELATIONSHIP TO YOUR PARENTS OR LEGAL PROOF OF TUITION FEES WAIVER AS PER INDICATED IN
GUARDIANS? THE ADMISSION LETTER
POINTS CLAIMED
93 CONFIRMATION OF ACCEPTANCE FOR STUDIES 30
94 MAINTENANCE
95 TOTAL 30
PART 6 > ADDITIONAL INFORMATION

ADDITIONAL INFORMATION
96 IS THERE ANY OTHER INFORMATION YOU WISH TO BE -I WOULD WISH YOU CONSIDER THE PREVIOUS VISAS
CONSIDERED AS PART OF YOUR APPLICATION? GIVEN TO ME TO TRAVEL TO AUSTRALIA WHERE I WENT
AND RETURNED HOME.
-CONSIDER ALSO MY TRANSCRIPTS FOR
UNDERGRADUATE STUDIES REGARDING THE ENGLISH
PROFICIENCY LEVEL OF WHICH ALONG WITH MY
MASTERS DEGREE IN UGANDA CHRISTIAN UNIVERSITY
WERE ASSESSED TO PROVE MY PROFICIENCY LEVEL.
-ALSO CONSIDER THAT I PASSED AN ADMISSION
INTERVIEW TO BE ADMITTED IN THE PHD IN NURSING
AND MIDWIFERY AFTER SUBMITTING MY RESEARCH
PROPOSAL. FOR DETAILS, CONTACT DR. JANICE
RATTRAY AT J.Z.RATTRAY@DUNDEE.AC.UK .
BRP Collection Location:

POST OFFICE - DUNDEE
4 MEADOWSIDE
DUNDEE
DD1 1AA

DECLARATION
I declare that the information given on this form whether input by myself, input on my behalf by a third party or automatically pre-populated is complete
and correct to the best of my knowledge and belief. I also declare that the photograph submitted with this form is a true likeness of me. I confirm that if,
before this application is decided, there is a material change in my circumstances or new information relevant to this application becomes available, I
will inform the United Kingdom diplomatic mission handling my application.
I understand that all information provided by me will be processed by the Home Office in accordance with the Data Protection Act 1998. I am aware
that the Home Office is the data controller in relation to the information provided by me in this application form. I am aware that the information I
provide, including biometric data, will be treated in confidence, but it may be disclosed to other government departments, agencies, local authorities,
foreign governments, and other bodies, to enable the Home Office or those bodies to perform their functions. Any disclosures will be in accordance with
the Data Protection Act 1998. I also understand that the information provided by me may also be used for staff training purposes.
I declare that the documents that I have supplied with this application are genuine and the statements I have made with this application are truthful. I
understand that the Home Office (or a trusted third party) may make reasonable checks to confirm the accuracy and authenticity of evidence I have
provided and documents I have submitted with this application. I further understand that the Home Office (or a trusted third party) may also make
reasonable checks on any sponsors to my application to verify statements contained in the application and establish that I will comply or have complied
with the terms of any visa granted.
I understand that UK entry clearance applications may be handled by British Missions in other locations, including outside the country in which I have
applied for entry clearance and that this may involve the transferring of my application and supporting documents to and from another Mission. I
understand that the Home Office will be responsible for transferring my application and supporting documents safely. I understand in these
circumstances my application will still be handled in line with Home Office published customer service standards.
I understand that the fee payable is for an application processing and entry clearance decision-making service, not for the guaranteed delivery of a
visa, therefore I will not be entitled to a refund should my application for entry to the UK or Commonwealth and Overseas Territories be refused or
granted for a shorter time period than I applied for. I also understand that my visa application fee will be refunded only if the application is withdrawn in
writing within 3 months and 7 days of the original date of application and prior to the submission of biometric data or any processing taking place.
I also understand that the information provided by me, or information made available to the Home Office during the processing of my application, may
be shared with my sponsor(s) or any person(s) acting on their behalf or any applicant linked to my application (for example to my spouse / partner if we
apply for visas for a trip together) for the sole purpose of considering my application.
I am aware that if there is any information I do not want you to disclose to them I will tell you by enclosing a letter with my supporting documentation. If
such requests prevent you from making legitimate inquiries, my application may be refused.
I am also aware that my application will be automatically refused and I may be banned from going to the UK for 10 years if I use a false document, lie or
withhold relevant information. I may also be banned if I have breached immigration laws in the UK. I am further aware that should I use a false
document, lie or withhold relevant information my details may be passed to law enforcement agencies.
I understand that I may be required to provide a record of my fingerprints and a photograph of my face (“biometric data”) as part of my application. If I
refuse to do so, my application may be treated as invalid and, if so, will not be considered further. (See Statutory Instrument 2006 No 1743 - The
Immigration (Provision of Physical Data) Regulations 2006, Regulation 7(1)).
I understand that providing biometric information as part of an application is confirmation of consent to having biometric information checked at the UK
border to verify identity. Where I am applying for entry to the UK, I accept that the payment of an Immigration Health Surcharge may be required. I
understand that separate rules governing whether the Surcharge is applicable and when a refund would be due are available via the visas and
immigration pages of the gov.uk website.
I am aware that I may be billed for any NHS medical treatment undertaken in the UK and that I do not have recourse to public funds during my stay in
the UK. I understand that if I fail to pay NHS debts incurred by me this could adversely affect future entry clearance applications I make.
I understand that my details may, in certain circumstances, be passed to fraud prevention agencies to prevent and detect fraud and money laundering.
I also understand that such agencies may provide the Home Office with information about me. Further details explaining when information may be
passed to or from fraud prevention agencies and how that information may be used can be obtained from the Home Office website.
I am aware that it is an offence under the Immigration Act 1971 (as amended) to make a statement which I know to be false, or not believe to be true, in
order to obtain a visa/entry clearance to the UK.
I hereby apply for a transfer of a visa/entry clearance to the United Kingdom.
APPLICANT'S SIGNATURE:
DATE SIGNED:
FORM COMPLETED BY: THIERRY CLAUDIEN UHAWENIMANA
GWF037146840

GW F 037146840

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Online Visa Application APPLICATION FOR UNITED KINGDOM ENTRY CLEARANCE

APPLICANT BIOGRAPHIC DETAILS AND TRAVEL DATE

APPLICATION ID: GWF037146840

GIVEN NAMES: THIERRY CLAUDIEN

FAMILY NAME: UHAWENIMANA

DATE OF BIRTH: 26 MAR 1981

PLACE OF BIRTH: RUSIGA, RULINDO

PASSPORT NUMBER: PC 169321

VISA APPLICATION NUMBER:

DATE OF PLANNED ARRIVAL 07 SEP 2015

VISA APPLICANT CONTACT DETAILS

APPLICANTS EMAIL tcuhawenimana@gmail.com

APPLICANTS PRIMARY 250788586768

APPLICANTS SECONDARY 250722958316

PAYMENT REFERENCE: 4060272443

USER PAY FEE: USD 94.40

TOTAL FEE: USD 610.00

PAYMENT MADE: YES - ONLINE

PAYMENT DATE: 07 AUG 2015

VISA APPLICATION SUBMISSION

SUBMISSION METHOD: STANDARD

>>OFFICE USE ONLY

CATEGORY: PBS TIER 4 STUDENT

TYPE: TIER 4 (GENERAL) STUDENT

Created: 07/08/2015 Page 1 CODE

I hereby apply for a transfer of a visa/entry clearance to the United Kingdom.

FORM COMPLETED BY: THIERRY CLAUDIEN UHAWENIMANA

Created: 07/08/2015 Page 2 CODE

APPLICANT NAME: Thierry Claudien UHAWENIMANA

FORM: Tier 4 (General) Student

PART 1 > PASSPORT AND TRAVEL INFORMATION

DOCUMENT NUMBER PC 063916

ISSUING AUTHORITY IMMIGRATION SERVICES

DATE OF ISSUE 24 DEC 2007

DATE OF EXPIRY 24 DEC 2012

IS THIS DOCUMENT LOST, STOLEN OR IN YOUR POSSESSION IN YOUR POSSESSION

Created: 07/08/2015 Page 3 CODE

19 HOW LONG DO YOU INTEND TO STAY IN THE UK? FOUR YEARS

PART 2 > PERSONAL DETAILS AND TRAVEL HISTORY

DATE OF ISSUE 22 OCT 2010

DATE OF EXPIRY 22 DEC 2010

ISSUING AUTHORITY AUSTRALIA HIGH HC

TYPE OF VISA ISSUED VISITORS VISA

DATE OF ISSUE 03 FEB 2011

DATE OF EXPIRY 03 MAY 2011

ISSUING AUTHORITY SWAZILAND HC

26 HAVE YOU EVER TRAVELLED TO THE UK IN THE LAST 10 NO

Created: 07/08/2015 Page 4 CODE

31 HAVE YOU EVER VOLUNTARILY ELECTED TO DEPART NO

COUNTRY VISITED AUSTRALIA

REASON FOR THE TRIP ATTENDING A CONFERENCE

DATE OF TRAVEL 31 JAN 2011

COUNTRY VISITED SWAZILAND

REASON FOR THE TRIP ATTENDING A CONFERENCE

DATE OF TRAVEL 01 FEB 2012

COUNTRY VISITED UGANDA

REASON FOR THE TRIP STUDIES UNTIL JULY 2014

35 DO YOU HAVE A UK NATIONAL INSURANCE NUMBER? NO

PART 3 > FAMILY DETAILS

Created: 07/08/2015 Page 5 CODE

43 WHAT IS YOUR MARITAL STATUS? MARRIED / CIVIL PARTNER

Created: 07/08/2015 Page 6 CODE

PASSPORT NUMBER N/A