POSTGRADUATE APPLICATION FORM THE COMPLETED FORM MAY BE

POSTGRADUATE APPLICATION FORM THE COMPLETED FORM MAY BE
SUPPORTED BY NERC THE NHM OFFERS THREE POSTGRADUATE
077 APPLICATION FORM FOR POSTGRADUATE RESEARCH DEGREE APPEAL FORM

3 NATIONAL ADVICE CENTRE FOR POSTGRADUATE DENTAL EDUCATION CONFIDENTIAL
4 MINIMUM FACILITIES FOR UNE POSTGRADUATE RESEARCH STUDENTS1 1
9 KHARKIV NATIONAL MEDICAL UNIVERSITY FACULTY OF POSTGRADUATE TRAINING

University of Bristol

Postgraduate Application Form

The completed form may be returned by post, fax or sent as an e-mail attachment to the Faculty Office - Please follow the link from the on-line postgraduate prospectus to 'Contact Details'.

1. I wish to apply to the Faculty of :-
2. Department of :-
Previous Study at Bristol : Are you currently (or have you been) a student at this University. (Please supply information on your previous registration in Section F)		Yes / No

3. Proposed Area(s) of Study
By advanced taught programme (Certificate/Diploma/Master). Please state name of programme below.				Yes / No

By Research: please attach either a research proposal giving research area in sufficient detail to allow research topic and methodology to be assessed or a list of areas of research interest.				Yes / No
Masters Degree	Yes / No	Ph.D.	Yes / No
Other (please specify) e.g. MD

Section A Personal Information

4. Surname / Family Name

(block letters):

Title:

(Mr / Mrs / Ms / Miss)

5. First Names (s)

6. Date of Birth

Marital Status

7. Country of Birth

Nationality

Country of Permanent

Residence

Since

8. Home Address

Telephone

Fax

E-mail

Address for Correspondence

(if different from home)

Mobile Telephone

Fax

Are you registered disabled?

Yes / No

Nature of disability

Start date and method of study
Starting date	Month		Year
Method of study	Full time	Yes / No	Part time	Yes / No

Section B Finance
Proposed means of financial support
Name and address of person or organisation responsible for paying fees (if not yourself)
Is finance provisional or confirmed?

Section C Qualifications already obtained (or expected)
Degrees and Professional Qualifications
Title of Qualification	Conferring institution		Dates of Study		Class/Division/Grading



Please forward a transcript (officially translated if not in English) of your degree results.
Work Experience
Please indicate details of your recent principal appointments (you may provide a Curriculum Vitae instead if you wish)
Name / Organisation		Dates		Post Held

Section D English Language Proficiency

Is English your first language?

Yes / No

If English is not your first language or if the medium of instruction at your previous University was not English, please give details of any relevant qualifications in English language (e.g. IELTS date and score). Please forward copies of certificates for TOEFL or IELTS tests already taken. Please note IELTS is preferred.

Section E Names and Addresses of Referees

Please supply references using the standard form available on our web site. These must be completed and signed by the referee please (e-mail attachments will not be accepted).

First Referee -

Second Referee -

Section F Other Information

Previous Contact with the University

If you have already contacted any member of the University about your application, give his or her name and department.

Previous Registration / Member of the University of Bristol

If you are currently (or have you been) studying at the University please supply information on your programme of study, year of graduation and student number, if possible.

If you are a member of the University of Bristol or have academic status within the University of Bristol, please state in what category (academic/academic related/technical/other) and give title of appointment

Other Applications

Please state which other Universities in the United Kingdom, if any, you have applied to for postgraduate study; please indicate the area of research/taught programme applied for.

Additional Information

If you wish to give additional information please use this section

Source of Information

Where did you find out about opportunities for postgraduate study in the University of Bristol

Name

 

Date of Application

 

All decisions by the University are taken in good faith on the basis of the statements made on your application form. If the University discovers that you have made a false statement or have omitted significant information on your application form, for example in examination results, it may withdraw or amend its offer, or terminate your registration, according to the circumstances. The information given on this application form will be electronically stored and used for administrative purposes by the University in accordance with the provisions of the Data Protection Acts 1984 and 1998.

FOR THE UNIVERSITY'S USE ONLY

To the Department considering the above application:

Please indicate below your decision on this candidate, together with any conditions required if an offer is recommended.

NAME OF CANDIDATE:

POSTGRADUATE APPLICATION FORM THE COMPLETED FORM MAY BE

ACCEPT for (Qualification title):

Qualification aimed for:

ADVISER:

STARTING DATE:

MINIMUM PERIOD OF STUDY

State whether full-time or part-time

SUBJECT OF STUDY/PROPOSED TITLE OF RESEARCH:

CONDITIONS:

POSTGRADUATE APPLICATION FORM THE COMPLETED FORM MAY BE

REJECT

Please give reasons for rejection:

POSTGRADUATE APPLICATION FORM THE COMPLETED FORM MAY BE

Signed ……………………………………………………. Date ……………………………..

Signed …………………………………………………… Date ……………………………..

POSTGRADUATE APPLICATION FORM THE COMPLETED FORM MAY BE Head(s) of Department/Representative(s)

For Faculty Use

Approved by……………………………………………… Date………………………………

Board/Committee/appropriate Officer, etc.

A) I UPDATE THE ENTIRE POSTGRADUATE STUDY PLAN EG
AFFIX TWO STAMP SIZE PHOTOGRAPHS POSTGRADUATE DIPLOMA IN CURRICULUM
APPLICATION FOR RECEIPT FOR NONACCREDITED POSTGRADUATE AND SPECIALISATION STUDIES

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