Form RD1 - Application to Register for a Research Degree

Form RD1 - Application to Register for a Research Degree

Please complete in BLACK ink using BLOCK CAPITALS

1. Programme Details

Registration sought:Master of Philosophy (MPhil)

Doctor of Philosophy (PhD/DPhil)

Mode of attendance:Full time Part time

Proposed start date:Month:JanFebMarAprMayJunJulAugSepOctNovDecYear: 2007200820092010

1. Applicant Details

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Surname/Family name:

First/Given name(s):

Date of Birth:

Gender: Male Female

Title: MrMrsMissMs

Other (please specify):

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Correspondence Address

(We will send ALL correspondence here, so it is important that you let us know of any change of address):

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Postcode:

Telephone:

Mobile phone:

Fax:

E-mail:

Home Address

(If different from your correspondence address)

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Postcode:

Telephone:

Mobile phone:

Fax:

E-mail:

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If you are disabled or have a medical condition, please enter the appropriate code from the following list in the box:

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0No special facilities required

1Dyslexia

2Blind / partially sighted

3Deaf /hard of hearing

4Wheelchair user / mobility difficulties

5Need personal care or assistance

6Mental health difficulties

7Unseen disability (e.g. epilepsy, heart condition)

8Two or more of the above (please specify)

9Disability not listed above (please specify)

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Details of any facilities / support required:

1. Tuition Fee Status

Country of Birth:

Nationality:

Country of domicile or area of permanent residence:

If you were born outside the European Union, please give:

• Date of first entry to the EU:

• Date on which you were granted permanent residence in the EU:

Payment of Tuition Fees

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Who will pay your fees if offered a place?

Yourself

Your Employer

Other Sponsor

Name and address of sponsor (if applicable):

Postcode:Telephone:

Fax:E-mail:

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Please give details of any scholarships or grants you have already obtained or have applied for:

Already obtained:

Applied for:

1. Employment details (most recent first – please continue on a separate sheet if necessary)

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Dates

Organisation and Department

Job Title and main responsibilities

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Current Employer’s address & contact name (if applicable):

Postcode:Telephone:

Fax:E-mail:

1. Education Details

Please give school / college / university attendance in chronological order since the age of 16:

(please continue on a separate sheet if necessary)

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Institution

Degree Title

Class of Award

Date From

Date To

Full/Part time

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Please enclose copies of your certificates of qualification/transcripts. A translation in English should be provided where appropriate.

Additional skills / qualifications

Training and Experience:(Please provide details of any work experience or other activities [with dates] relevant to this application, and of any research papers, written reports, publication etc.)

Please describe any proficiency in using computers: (stating any qualifications you may hold or computer packages with which you are familiar)

What language skills do you have? (Please state language and level of proficiency: basic, intermediate, or fluent):

If English is not your first language, please tell us about any English language qualifications you hold:

IELTS: Overall Score:Reading: Writing: Speaking:Listening:

TOEFL: Computer:Written:Internet: TWE:

Other qualification (please specify):

Date qualification obtained:

If not already obtained, please indicate which test you will take and the date on which you will be examined:

1. Referees

Please give names and addresses of two referees. At least one referee should be able to comment on your academic / professional ability. Please complete your personal details on the enclosed reference sheets and pass them to your referees for completion.

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Name:

Occupation:

Address:

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Postcode:

Telephone:

Fax:

E-mail:

Name:

Occupation:

Address:

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Postcode:

Telephone:

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E-mail:

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1. The Research Proposal

Please provide the proposed title and aims/objectives of your research:

Title:

Aims and objectives:

1. Context for Research Programme

Please name any collaborating establishment(s), if any:

What is the relationship between work to be undertaken at the collaborating establishment and at the university or elsewhere?

Please provide any details of facilities available for the investigation:(e.g. laboratory space, specialist equipment)

Adviser(s), if any:(Name, qualifications, post held, place of work, research interests, previous supervisory experience)

1. Statement by the applicant

I understand that by signing this application form I certify that the information I have provided is true, complete and accurate.

If the University of the West of England has reason to believe that I or any other person have given false information or have omitted any information requested in the instruction or application form or made any misrepresentation, the University will take whatever steps considered necessary to establish the authenticity of my application. I accept that if I do not fully comply with these requirements, the University reserves the right to cancel my application and I shall have no claim against the University.

Signature:

Date:

Please complete your personal details on the two reference sheets and pass them to your referees for completion. Return the application form, copies of transcripts / certificates and copies of academic papers to:

The Research Centre (Bungalow)

BristolBusinessSchool

University of the West of England

Frenchay Campus

Coldharbour Lane

Bristol

BS16 1QY

 or

 + 44 (0)117 328 2600

+ 44 (0)117 328 2600

1. How did you learn about this award? (Please tick all appropriate)

ProspectusProspectus databaseAdvertisementUWE website

Careers adviceWord of mouthStudylink CD-ROMECCTIS

EmployerFriendBritish Council

Other: (please state)

1. Have you previously studied at this University?

YesNo

If ‘Yes’, please give your:

UWE student registration number:Alumni number

The Data Protection Act 1988

The information which you give on your application form will be used for the following purposes only:

• To enable your application for entry to be considered.
• To enable the university to compile statistics, or to assist other organisations or individual research workers to do so, provided that no statistical information which would identify you as a person will be published
• To enable the university to initiate your student record

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For office use only

Director of Studies (Name, qualification, post held)

Currently supervising:MPhilPhD

Successfully completed supervisions:MPhilPhD

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Second Supervisor [1](Name, qualification, post held)

Currently supervising:MPhilPhD

Successfully completed supervisions:MPhilPhD

Second Supervisor [2] (Name, qualification, post held)

Currently supervising:MPhilPhD

Successfully completed supervisions:MPhilPhD

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Recommendation of the supervisory team

• We support this application and believe that the candidate has the potential to complete successfully the programme of work proposed.

• We recommend that the applicant be registered for the University’s research degree.

Signed:Name:Date:

Signed:Name:Date:

Signed:Name:Date:

Recommendation of the Dean of the Faculty¹ (affiliated institutions see note below)

I confirm that this applicant has been submitted to independent faculty scrutiny and the following requirements have been met (please tick):

□any referees required by the regulations have been consulted and the references are attached;

□the proposed supervisory team is satisfactory;

□the supervisors (where appropriate) have been closely involved in the preparation of the application and the clarification of the structure of the proposed project;

□where collaboration has been arranged, a letter from the collaborating establishment is provided;

□the conditions of work are satisfactory and the necessary resources are available;

□an adequate programme of formal study or course of reading has been proposed;

□thought has been given to any possible need for confidentiality, and a topic chosen which is not likely to pose problems with the collaborating establishment²;

□any financial support from the faculty detailed in Section 3 is available;

□ethical issues have been considered and any necessary ethical approval is being sought;

□any questions regarding the candidate’s competence in the English language have been considered and, where appropriate, dealt with.

I support this application and recommend that the applicant be registered as a candidate for the University’s research degree.

Signed:Name:Date:

¹ In the case of institutions affiliated to the University with regard to research students this form should be signed by the post holder recognised by the University as equivalent to the Dean.

² Where the need for confidentiality has been identified, a letter of explanation is required.

Expected start date of registration:

Amount of time (hours per week average):

Expected duration of programme:

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