Check the activity before counting hours. Use the institution’s programme-specific term dates and record combined hours across roles.
Prepared by: ____________________ Date: __________
| Role / activity | Contract / duties | Week and actual hours | Term status / confirmation |
|---|---|---|---|
| Employer or activity 1 | ____________ | ____________ | ____________ |
| Employer or activity 2 | ____________ | ____________ | ____________ |
| Placement / voluntary activity to review | ____________ | ____________ | ____________ |
| Combined weekly total | ____________ | ____________ | ____________ |
| Course / permission / term-date source | ____________ | ____________ | ____________ |
Decisions and next actions
Does any activity involve self-employment, ownership or a statutory role?
________________________________________________________________
________________________________________________________________
Who confirmed the proposed start date and conditions?
________________________________________________________________
________________________________________________________________
What must be reviewed before extra shifts or a post-study role?
________________________________________________________________
________________________________________________________________
Keep this completed sheet privately. Do not enter passport numbers, bank details or medical records in a public form. Planning resource; it does not decide eligibility.
Student Visa Mag · Information checked 15 October 2026 · https://studentvisamag.com/resources/student-visa-work-hours-pack/
Planning resource, not an official application form or eligibility decision.