Application for the Centre for International Health and Development (CIHD)

AHRI/UCL MSc Studentship2018/19

Application for theAfrica Health Research Institute

MSc Scholarship

Academic Year 2018-19

Sponsored by

University College London

Before completing this application, please note that:

• The scholarship application process precedes and is separate from the UCL MSc application process, the successful candidate will be expected to complete an application for a taught programme of graduate study at UCL for the academic year 2018/19, assistance will be provided with this.
• The scholarshipis exclusivelyto study for a taught MSc at UCL.
• Scholarship deadlines are adhered to strictly. No scholarship application will be accepted after the deadline date indicated.
• A selection committee will consider applications. The decision of the selection committee is final and not subject to appeal.

Complete applications must have been submitted 5pm on Friday 11th May, 2018

A. Personal Details

Title Mr Mrs Ms Miss Dr Gender Female Male

Date of Birth:

Surname:First Names:

e-mail address:

Nationality:

Current country of residence:

B. Correspondence Details

Home address:

Correspondence address if different:

C. Programme of study for which you wish to apply

Please read the details of the course you wish to study carefully, to ensure that the course you select is aligned with your academic interests and career aspirations

D. Academic record

A scanned copy of your academic transcript must be submitted with your application. Please see guidelines for further details.The successful candidate will be required to provide a copy of an official transcript from the Academic Registry or Student Records office at your institution as a condition of enrolment on an MSc at UCL. The transcript must be: on institutional-headed paper; stamped and signed by the issuing office

We may request proof (copies of award letters/certificates) of the information you give below.

*Please enter in correct format for your degree, i.e.: don’t try to convert to UK or any other mark system

E. Employment history

Please provide any employment details you believe to be relevant including:

F. References

Please provide details of two referees. At least one of your references must be: academic and someone who has taught you at degree level. If you wish you may provide one professional reference in place of the second academic reference. Please ensure you have spoken to your chosen referees so they are expecting an invitation to provide a reference for you, and are happy to do this. When providing the email address for your referee please use an academic or professional one rather than a personal one, e.g. rather than

G. Supporting statement

Please describe your academic interests and reasons for applying for this studentship. Detail your career objectives and any relevant non-academic achievements as well as any publications you may have. Outline any other relevant experience including attendance at specialist workshops or short courses. If appropriate, please indicate which options/ modules you are likely to be interested in.

This section must be no longer than 1000 words

H. Declaration

I declare that the information supplied by me on this form is, to the best of my knowledge, accurate and complete.

I understand that my application is valid only if all required information is provided.

Applicant’s Signature:Date:

Please return this form by emailby 5pm on Friday 11th May, 2018to: with ‘AHRI/UCL MSc Studentship 2018/19’ in the subject header. Acknowledgment of receipt will be sent by e-mail

CONFIDENTIAL—AHRI Office Use Only

(Applicants, please do not write in the areas below.)

Scholarship Application No:Date received:

1