Application for Pre-Registration to MPhil/PhD Programme of Study
School to which you are applying:
Qualification aimed for: MPhil or MPhil/PhD or PhD*
Do you wish to study: Part-time or Full-time*
* Please delete as appropriate
Please type this form or complete it in black ink in block capitals
SECTION A – PERSONAL DETAILS
Surname/Family Name: Other names:
Title (Mr/Mrs/Rev etc):Date of Birth:
Nationality:Country of Permanent Residence:
Permanent Home Address
Address for Correspondence (if different from home address)
Telephone No. (daytime/work)Telephone No. (evening/home)
Email:
SECTION B – RESIDENTIAL CATEGORY
UK/EU National, resident in the European Economic Area (EEA) for last 3 years
UK/EU National, temporarily employed outside the EEA
Non-EU National, exempt from Immigration Controls and resident in UK for last 3 years
Non-EU National, with Refugee Status or Exceptional Leave to Remain
National of Norway, Iceland or Liechtenstein in the UK as Migrant worker
None of the above
If not British or European Union National, date of most recent entry to the UK
SECTION C – FUNDING
Will you be paying your own feesYes No
If no please give details of who will be paying your fees.
SECTION D – QUALIFICATIONS
List all previous or current University or tertiary level courses followed starting with the most recent.
Attach a transcript if at all possible
University/College / Dates of Attendance / Qualification obtained/or aimed for / Date of Award / Grade/
Classification
Other professional or relevant qualifications not listed above
If English is NOT your mother tongue, give details of any English Language Courses taken and attach if possible a certificate of proficiency showing ability to speak, write and understand English
SECTION E – OCCUPATIONS
List, starting with the most recent, all past and present occupations with dates:
FromTo
SECTION F – OTHER RELEVANT EXPERIENCE
Give details of experience or other information (eg publications/conferences attended) relevant to your proposed programme of study:
SECTION G – ACADEMIC REFEREES
Please give details (including name, address and a contact telephone if one is available) of two academic referees who will support your application. Please note that academic referees cannot be the same people as those likely to supervise your research
NameName
AddressAddress
Tel:Tel:
Email: Email:
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SECTION H – RESEARCH PROPOSAL
NB: Before completing this section of the application form, please discuss your proposed area of research with the relevant contact within the school to which you are applying.
Part 1
Please provide a broad outline of your of proposed area of research (approx 200 – 300 words). Please try and include the following.
- aims and objectives of your proposed area of research
- a brief bibliography
Please continue on a separate sheet where necessary
Part 2
When completing your full research proposal for registration you are required to consider the following:
- Proposed methods for gathering, analysing & interpretation of evidence. Please include the reasons for selecting those methods.
- A provisional timetable of your research through to the completed thesis. Please include where appropriate details of any expected overseas field-work.
- Any specialised training and/or other resources that may be necessary to assist with your research.
If any of the above information is available at this stage please include it below.
SECTION I – SIGNATURE OF APPLICANT & DATA PROTECTION STATEMENT
I agree to St Mary’s University processing personal data contained in this form, or other data which the University may obtain from me or other people, whilst I am a student. I agree to the processing of such data for any purpose connected with my studies or my health and safety while on the premises or for any other legitimate reason.
I confirm that all the information given in this application form is accurate to the best of my knowledge
Applicant’s Signature Date
SECTION J – ADDITIONAL STATISTICAL DATA
Giving this information is voluntary. It is required for statistical purposes only and will not be made available to staff considering the application for admission. Please check the appropriate options below.
Gender / / / Male / / Female
/ / / / /
Ethnic Origin / / / 11 – White: British / / 12 – White: Irish
/ / / / /
/ / / 19 – Other White background / / 21 – Black or Black British: Caribbean
/ / / / /
/ / / 22 – Black or Black British: African / / 29 – Other Black background
/ / / / /
/ / / 31 – Asian or Asian British: Indian / / 32 – Asian or Asian British: Pakistani
/ / / / /
/ / / 33 – Asian or Asian British: Bangladeshi / / 34 – Chinese
/ / / / /
/ / / 39 – Other Asian / / 41 – Mixed: White and Black Caribbean
/ / / / /
/ / / 42 – Mixed: White and Black African / / 43 – Mixed: White and Asian
/ / / / /
/ / / 49 – Other Mixed background / / 80 – Other Ethnic background
/ / / / /
/ / / 90 – Not given (UK Domicile) / / 99 – Overseas Domicile
/ / / / /
NOTES TO THE APPLICANT
This application will be submitted to the Sub-committee for Research Students. If approved, you will receive confirmation in writing and forms for registration ad payment of fees. You will be eligible to register with the University to enable you to work on your research proposal for a period of 6 months.
On completion of your research proposal you will need to submit an APPLICATION FOR ADMISSION TO READ FOR THE DEGREE OF MASTER OF PHILOSOPHY (MPhil), DOCTOR OF PHILOSOPHY (PhD) OF THE UNIVERSITY OF SURREY. This is submitted to the Sub-committee for Research Students at St Mary's University. If the sub-committee are happy with the application it will then be forwarded to Liverpool Hope University for formal approval.
If your initial registration does not proceed onto full registration as an MPhil/PhD student you will receive a full explanation for this.
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