Rosalind Franklin Scholarship

Rosalind Franklin Scholarship

Scholarship Application Form

Closing Date for Applications:Friday 21 July2017

The University of Wolverhampton: Confidential

Rosalind Franklin Scholarship

Application Form 2016/17

Please complete this form using black ink or type. Please send completed applications to: MRO Admissions Unit, FSE, University of Wolverhampton, Wulfruna Building (Room MA105),Wulfruna Street,Wolverhampton, WV1 1LY, West Midlands, or email to by Friday 21 July 2017.

If completed by hand, please use BLOCK CAPITALS

Section 1 - Personal details

Title...... (Miss, Mr., Mrs., Ms)

Surname/Family Name...... First/Given Name(s)......

Date of Birth......

Correspondence Address......

......

...... Postcode......

Telephone Number (Home) ...... (Mobile) ......

email Address......

Section 2 –Academic Qualifications

Please list below your academic qualification/s (in chronological order; most recent being first). Include School and College programmes only.

Qualification School and College (with dates of attendance) Results (if applicable)

(i.e. 'A’ Level and subject)

......

Section 3- Sponsorships, Scholarships & Prizes

YearScholarship name and awarding bodyAmount/Level

(please advise if you have been awarded

a scholarship, or if you have applied for

one and are waiting to hear the outcome)

......

YearPrizeAmount/Level

......

Section 4 – Employment History

Please list below positions held or work experience (in chronological order)

Year Position Employer

......

Attach additional sheets if necessary

Section 5- Personal statement

Please give reasons why you believe you should be considered fortheRosalind FranklinScholarship. The scholarship will be awarded on the basis of academic merit and personal characteristics. In respect of personal characteristics, applicants should be able to show that they: are enthusiastic, highly motivated and determined to succeed academically and professionally; have a strong commitment to self-development and take a pro-active and committed approach to their education; possess good communication and interpersonal skills; are good team players and demonstrate team working skills; and have an awareness of and interest in the STEM.

......

Please continue on a separate sheet if required.

The reference is enclosed

It has been completed by (give name): ......

I understand that the information I have provided will remain confidential to the Selection Panel. I confirm that the information I have provided is accurate, and understand that the provision of false information may lead to the withdrawal of any scholarship award.

Signature...... Date......

Final Checklist:

⁯ Have you completed all sections of the application form?

⁯ Have you provided above the name of your Referee?

⁯ Have you signed and dated your application form?

⁯ Have you enclosed your Reference?

⁯ Have you enclosed your CV?

The completed application form along with a CV and the reference should be submitted to arrive no later than Friday 21 July2017, to:

FSE - MRO Admissions Unit (Room MA105)
Faculty of Science and Engineering
University of Wolverhampton
Wulfruna Building
Wulfruna Street
Wolverhampton

WV1 1YL
West Midlands

or email to

You will receive correspondence acknowledging receipt of your application.