WMG Applied Engineering Programme

WMG Applied Engineering Programme

Expression of Interest Form

Academic Year of Entry (eg 2014/2015)

If you have any questions about completing this form please contact the Programme Coordinator, Julie Rawlinson, 024 765 28077 or email

Section 1
Personal Details
Title
Last name
Forename(s)
Date of Birth (dd/mm/yyyy)
Nationality
Do you require a visa to study in the UK? / Yes No
Current Home Address
Postcode
Home Telephone Number
Email Address
Section 2
Academic History
Please give details of your highest relevant qualification
Name of Institution
Date attended (eg 1995-1998)
Qualification awarded and grade/mark achieved
Date awarded
Principle subjects taken and other relevant qualifications
Academic Interest and Purpose of Study
Please use this space to briefly describe your area of expertise, your aspirations and what you hope to achieve from your study with WMG. Please also indicate below which specialism you are likely to follow (this may be changed at a later date).
Manufacturing Systems /
Product Creation /
Business /
Other - please give details /
Section 3
Employment History
Name of Current Employer
Position held
Date From
Company Name
Company Address
Postcode
Current department
Current location
Your direct line phone number
Your work email address
Previous Employment
Total number of years of industrial experience?
Have you have discussed this application with someone in your company? / Yes No
Your Line Manager Details
Name
Job title/role (in full)
Business unit/department (in full)
Business address (in full if different from above)
Postcode
Telephone
Your Training Manager Details (if applicable)
Name
Job title/role (in full)
Business unit/department (in full)
Business address (in full if different from above)
Postcode
Telephone number
(including area code and extension if applicable)

If you have an up to date CV available detailing any previous employment history, please attach it to this form

Please note: this programme is for industrially sponsored students only. A further Fees and Billing form will be required once sponsorship is confirmed.

Signed / Date

University of Warwick | WMG Applied Engineering Programme Expression of Interest Form