Post Graduate Application Form
Course
Course title
Choice of subject/
specialisation if applicable
Academic year in which place required
Candidate
Title
Surname
Other names
Previous surname (if appropriate)
Address
Permanent home address
Telephone at this address
Address for correspondence (if different)
Telephone at this address
Personal Details
Gender
Status
Date of birth
Country of birth
If not born in UK state date of entry  
First entry
Last entry
Country of permanent residence
Nationality
Education since leaving school
Name & address of last or present Educational Institution attended
From (date)
To (date)
Mode of attendance (full-time, part-time etc)
Course taken
Result obtained
Other Further Education Institutions attended
Name of Institution (2)
Course
From (date)
To (date)
Name of Institution (3)
Course
From (date)
To (date)
Name of Institution (4)
Course
From (date)
To (date)
This Institution
If you have previously attended this institution please give year of entry for the first time and previous registration number (if known)  
Year
Registration number
Examinations already taken or qualifications obtained
NB. Candidates holding a general or modular degree should give details of subjects studied to degree level.
Examining body
Date of Exam
Subject
Level
Pass/Fail
Grade
Examining body
Date of Exam
Subject
Level
Pass/Fail
Grade
Examining body
Date of Exam
Subject
Level
Pass/Fail
Grade
Examinations to be taken or results awaited
NB. See note on above section
Examining body
Date of Exam
Subject
Level
Examining body
Date of Exam
Subject
Level
Examining body
Date of Exam
Subject
Level
Industrial Experience
Present Employment  
Name of Employer
Address
Nature of Employment
Previous Employment  
Name of Employer
Position
Previous Employment  
Name of Employer
Position
Previous Employment  
Name of Employer
Position
Fees
Who will provide finanical support for you for the duration of the course?

 

 

Yourself
Local Education Authority
Employer
Research Council (eg ESRC, SSRC, MRC etc)
Training Initatives
Other (please specify)
Sponsor
Name
Address
Applied for?
Approved?
Referees
Please give details of two referees (they should be able to comment on your acedemic ability and suitability for the course proposed)
Name (1)
Status
Address
Name (2)
Status
Address
Additional Information
Please give any additional information which might be relevent including your reasons for applying for the course.
Special Needs
Please tick the box if you have a special physical or sensory handicap which might in some way affect your studies at the University, or may require special facilities or treatment.
How you found out about this course
Please let us know how you found out about this course (poster, leaflet, webpage, exhibition etc)
Sending this form  
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