Research Degrees Application Form
Please complete this form in BLOCK CAPITALS
Course detailsSubject area / ______
Award title / MPhil / MPhil/PhD / PhD / DBA EdD
DProf Health & Social Care DProf Science & Technology
DProf Practical Theology DProf Laws DProf Applied Linguistics
MProf PG Dip Professional Research MD(Res)
Mode of study / Full-time / Part -time / Proposed date of entry -
Personal details
Title______/ Male/Female
Surname/Family name______
Previous surname______
First name(s)______
Date of birth (dd-mm-yy) --
Permanent home address * (see note)
______
______
______
______
Postcode
Telephone no.______
Email address______/ Contact address (if different from home address)
______
______
______
______
Postcode
Telephone no.______
Email address______
Fees information
Who is expected to pay your fees? / Yourself / Sponsor / Research funding body
If you have indicated that a sponsor or research funding body is expected to pay your fees,please provide the name and contact details of the sponsor or funder. / Name and contact details of sponsor/funding body ______
______
______
Further details
Country in which you have unrestricted right to reside/live / ______
Country of birth / ______
Nationality (as stated on your passport) / ______
Have you been permanently resident in the UK/EU for the last three years for other than educational purposes? Yes No Please give date of entry ______
Do you have any unspent criminal convictions in any country? Yes No
Passport number (non-UK/EU only) ______
Learning support needs
Do you have a disability, medical condition or learning difficulty?
(If your answer is ‘yes’ Please give brief details; our Student Support Service will contact you and note that we will require documentary evidence of the above in order to make adjustments to the learning environment for you.)
______
______/ Yes / No
Education, qualifications and training
Higher education/Further education/Secondary education (please list most recent first)
Name of institution / From (mm/yy) / To (mm/yy) / Full-time?
Continue on separate sheet if necessary
Qualifications completed or relevant training undertaken (please list most recent first)Qualification / Subject / Grade / Date awarded
Continue on separate sheet if necessary
Qualifications pending or continuing trainingQualification / Subject / Expected grade / Date (mm/yy)
Continue on separate sheet if necessary
Evidence of English language levelFor English language level required please visit:
www.anglia.ac.uk/ruskin/en/home/central/rds/services/research_office/research_degrees/prospective_students.html
If you’re not native speaker, please complete one of the two options below
Name of last examination taken (eg IELTS or TOEFL)……...... Result…………………
Original/copy of certificate enclosed? Yes □ No □
If ‘No’ please explain…………………………………………………………………………………………………………………
OR Evidence of study through the medium of English enclosed? Yes □ No □
Professional body membership
Professional body / Date joined
Continue on separate sheet if necessary
EmploymentCurrent employer
Name of organisation______
Address______
______
Department______/ Job title______
Date appointed______
Continue on separate sheet if necessary
Previous employers (please list most recent first)Organisation / Position held / From (mm/yy) / To (mm/yy)
Continue on separate sheet if necessary
Supporting information
Outline research proposalPlease indicate in general terms the area of your research interest. Please use the headings below to form the basis of your outline. Approximately one to two sides of A4 are expected.
For MPhil/PhD/MD(res):
· Proposed area of research
· Aim and focus of the study
· Context for the research
· Research methodology, including data collection and analysis
· Research skills
· Indicative references/publications
For MProf/DProf/DBA/EdD:
· Proposed area of research
· Professional context
· Aim and focus of the study
· Significance to you, your employer and professional practice
Approximately one to two sides of A4 are expected.
Outline research proposal
Please insert your research proposal below.
Our university reserves the right to submit any application to study for a research degree through TurnitinUK plagiarism detection software.
Referees – Please provide two references on letter headed paper, signed and dated. We require two academic references to support applications for MPhil and PhD. Applicants for Professional Doctorates (DBA, EdD and DProf) and MD (Res) are to provide one academic and one professional reference.
Organisation
Relationship to you
Reference enclosed Reference to follow / Name of referee 2
Organisation
Relationship to you
Reference enclosed Reference to follow
Provisional supervisor – If you have discussed your application with a particular academic member of staff, please state that person’s name here
Name______Telephone no.______
Email address______
Declarations
Do you have any unspent criminal convictions? Yes NoA criminal record will not necessarily be a bar to obtaining a place at Anglia Ruskin University.
A satisfactory Disclosure and Barring Service check will be required for successful applicants to courses which include placements where students work with children or vulnerable adults.
Data Protection Act 1998
I agree to the University processing personal data contained in this form or other data which the University may obtain from other people. I agree to the processing of such data for any purposes connected with my studies or my health and safety whilst on the premises or for any legitimate reason including communication with me following the completion of my studies.
In addition, I agree to the University processing personal data described as ‘sensitive data’ within the meaning of the Data Protection Act 1998, such processing to be undertaken for any purposes as indicated in the declaration above.
If my employer/sponsor is supporting my studies by paying my fees/allowing me study time I agree to my employer/sponsor being informed of the progress of my application and of my studies if I am accepted onto the course.
Agent referral
To be completed if applying with the assistance of an overseas recruitment agent
I confirm thatI give thefollowingAnglia Ruskin recruitment partner authorisationto discuss my application with staff at Anglia Ruskin University, and receive correspondence from Anglia Ruskin University on my behalf.
Company Contact person ………………………………………
Email Telephone no ………………………………………..
Declaration
I certify that, to the best of my belief, the information I have provided is complete and true.
Signature of applicant Date …………………
Signature of guardian Date …………………
if applicant is under 18 years
Supporting documentation
Please note that all applicants must include copies of the following when returning this application form:
· Academic certificates (officially translated if not UK)
· Academic transcripts, including subjects studied and grades achieved (officially translated if not UK)
· English language certificate (if not UK National)
· Photocopies of passport to include photograph and personal detail pages. Internationalapplicants currently residing in UKmust also provide photocopies of visa and immigration stamps.
· References (as outlined above)
This application will only be processed when the required documentation is received
Please submit your completed application form with supporting documentation as follows:
UK/EU applicants
Email: Fax: +44 (0)1245 607520
Post: Admissions Office, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, CM1 1SQ
International applicants
Email: Fax: +44 (0)1245 683690
Post: International Admissions, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, CM1 1SQ
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