College Bursary Scheme 2016/17

CollegeBursary Scheme 2016/17

You should refer to the Guidance notes for applicantsand the Frequentlyasked questions documents before you complete this form. You must also complete and return the Equal opportunities monitoring form.

Section A: Personal details
Surname: / Forenames:
Home address: / Title (Mr/Ms/Mrs/Miss/other):
Telephone numbers(please tick preferred number for correspondence)
Home:
Work:
Mobile:
Postcode:
Email (please tick preferred email address for correspondence)
Work:
Personal:
Section B: Study details(You do not need to have been formally accepted on to a programme of study in order to submit an application but you must have identified a preferred programme of study and academic provider and be in the process of applying)
Academic institution:(please include the name of the academic institution and the relevant department / school)
Programme of study title:e.g. Criminology: / Course type:e.g. BA, BSc, MA, MSc, PhD
Academic contact:e.g. personal tutor, admissions’ tutor, course leader
Name:
Role:
Email:
Telephone number:
Research component:e.g.8 week compulsory module on research design, additional optional research methods module and research thesis.
Method of study:
Full-time
Part-time
Distance learning
Other (please specify) / Course status (please tick one):
Application in progress
Provisional offer
Place accepted
Study in progress
Other (please specify)
Course start date(please estimate if unknown):
(Day / Month / Year) / Course end date(please estimate if unknown):
(Day / Month / Year)
Section C: Funding details
Funding applied for through the Bursary Scheme(please tick years funding applied for and state amount requested):
2016/17: £
2017/18: £
The period of study for which Bursary funding is applied for:
2016/17: For example,Sep 2016 to March 2017:
2017/18 (if applicable):For example, April 2017 to June 2017:
Totalcost of tuition fees for the programme of study over the period that Bursary funding is applied for:
2016/17: £
2017/18(if applicable): £
Have you applied for, or are you in receipt of,any funding from any other sources associated with this programme of study? This includes a loan from the Student Loans Company but does not include any personal loans.
Yes – Funding applied for but outcome pending
Yes – Funding confirmed / received
No
If YES: Please provide source, status of application, amount applied for / received and the period this will cover.Please also state what this funding will be used for, for example, tuition fees, subsistence, course materials etc.
Section D: Previous academic qualifications
Highest academic qualification currently held (please tick one only)
Doctoral e.g. PhD, DPhil, LLD
Master’s e.g. MA, MSc, MRes, MPhil, GDL
Undergraduate e.g. BA, BSc, LLB
HNC / HND or equivalent / A-Levels or equivalent
GCSEs or equivalent
No academic qualifications
Other (please specify)
Please list below all previous academic qualifications (most recent first):
Name and address of school, college, university / Qualificatione.g. BA / Subject / Result/grade achieved / Year completed
Section E: Current role
Police force: / Substantive rank/band/grade/job title:
Length of service in current role (in years and months): / Overall length of service (in years and months):
Briefly describe your current role and key responsibilities (maximum 250 words):
Word count:
Section F: Supporting information
The evidence you provide in this section will be used to decide whether you aresuccessful in your application. Please provide examples which demonstrate you have the ability and potential to complete your chosen programme of study successfully and that demonstrate your awareness of the potential benefits to yourself and others. Please be as concise as possible and take care not to exceed the specified word counts. Please state your total word count for each section.
Suitability: Please explain why you are undertaking, or want to undertake academic study at the level selected and why you have chosenthis particular programme of study? (Maximum 300 words)
Word count:
Personal development:Please outline what skills and knowledge you hope to develop through your studies and describe how you will use these to benefit you in your current role and/or future professional development. (Maximum 300 words)
Word count:
Knowledge exchange:Please describe how you will use the knowledge and experience gained through your studies to add value in your own force and/or the wider service. (Maximum 300 words)
Word count:
Task management:Please describe any potential challenges you are facing, or feel you are likely to face, in undertaking and completing the proposed programme of study and what measures you have taken, or will take, to address them. (Maximum 300 words)
Word count:
Evidence based practice:Please describe a project or task you have initiated, or taken a key role in, which has developed and / or promoted evidence based practice in your force or the wider service. Please briefly describe the project or task, what your specific role was, the value you added and what the outcome was. (Maximum 600 words)
Word count:
Section G: Details of your Line Manageror a Learning and Development leadfrom your force (to be completed by them)
Surname: / Forename:
Substantive rank/band: / Job title (if applicable):
Relationship to applicant: / Length of time known applicant (years):
Telephone numbers
Work: / Home:
Email:
Do you consider that the applicant has the ability to complete the programme of study they have applied for and to achieve the stated qualification?
Yes – please sign and date this section below
No / not sure – please respond to the following question before you sign and date below.
If No / not sure - please provide your reasons below. Completion of this section should follow a discussion with the applicant.
Signature:(By filling in this box electronically, your signature to this section is implied and accepted.) / Date:
Section H: Any other comments (OPTIONAL - for completion by the applicant)
Please use this section to provide any additional information which you feel it would be useful to share with the assessors. This section is optional and will not form part of the formal assessment process.You may leave this section blank.(Maximum 300 words)
Section I: Applicant declaration and sign off
The personal information collected on this and other forms during the application process will be used for the purposes of your 2016/17 College Bursary application and will be disclosed to all those who need to see them. The information will not be used for any other purpose. Please confirm by signing below that you give consent for your information to be used for the purpose of your application to the College’s Bursary Scheme.
I am aware that the College of Policing will create computer and paper records about me during the application process.
I declare that the information I have given is, to the best of my knowledge, accurate and complete.
Note: By filling in this application form electronically, your signature to this document is implied and accepted.
Name: / Date:
Signature:
College Membership: To be eligible to apply to the Bursary Scheme, youmust have pre-registered to become a College Member by joining the Members’ Hub on POLKA. Please check the box below to indicate that you have pre-registered as a member. Further information on membership can be found on the College’s website .
I have pre-registered and joined the Members’ Hub on POLKA

© – College of Policing Limited (2016)

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