1. PERSONAL DETAILS

Surname / First Name (s)
Date of Birth / Name by which
you like to be known
Nationality
Your permanent home address
Address 1 / Address 2
Town / County
Post Code / Home Tel
Mobile Phone / Email

2.EDUCATION

Please state the universities and accredited degrees that you have offers for, in your order of preference:

University
(for Oxford & Cambridge please also state college) / Degree Subject / Degree type
(e.g. BEng, MEng) / Accredited by The Engineering Council?
(see
1 / 
2 / 
3 / 
Please include a copy of your offer letter/s.

Please provide details of your education to date (excluding primary school):

Secondary School / College / Town / From / To

A2Levels/ Advanced Higher results (or equivalent eg International Baccalaureate, National Diploma):

Level
(eg A2 Level, Ad. Higher, IB) / Subject / Grade Achieved/Expected / Date obtained/to be obtained
Please include a copy of your paperwork confirming your results for exams already taken

AS Levels/ Higher results (or equivalent eg International Baccalaureate, National Diploma):

Level
(eg AS Level, Higher, IB) / Subject / Grade Achieved/Expected / Date obtained/to be obtained
Please include a copy of your paperwork confirming your results for exams already taken

3.ENGINEERING-RELATED WORK EXPERIENCE OR PAID WORK

Company and Location / Nature of Work undertaken / Year / Duration

4.FUNDING FOR YOUR DEGREE

Please tick as appropriate and provide details if you answer ‘yes’ to any of the following:

Statement / Yes / Detail
Applied for a Tuition fee loan / 
Applied for a Maintenance loan / 
Applied for a Maintenance grant / 
I will be first in my family to go to university / 
I come from a low income family (total household income < £40,000) / 
Copy of student finance “Notification of Entitlement” letter is attached / 
Please provide a copy of your “Notification of Entitlement” letter - if you do not yet have this, do not delay sending your application to us. Forward the letter to the Arkwright Office once you have received it.

5.REFEREE’S DETAILS

Please supply a referee - this may be academic or personal. Please ensure they are aware you are submitting their name:

Name / Position
Company / Address 1
Address 2 / Town
County / Post Code
Telephone / Email

6.SUPPLEMENTARY INFORMATION

Please provide the additional information requested below. The information should be supplied as a single document in pdf or Microsoft Word format; must occupy no more than two pages; and have the three sections in the same order as below:

1.Your medium and long term career aspirations in engineering – 250 words maximum

2.Your activities and / or interests of an engineering nature outside of your curriculum studies – 250 words maximum

3.Your other activities and interests – 250 words maximum

7.PUBLICITY

Please note: If you are awarded an Undergraduate Scholarship you will be required to actively promote the Arkwright ScholarshipsTrust, provide occasionalwritten articles and attend events when requested.

8.DECLARATION

 I certify that the statements on this form and my supplementary submission are true and correct.

Timeline for your application:

10thJuly 2016 / Closing date / Please email this completed form midnight on 10th July 2017.
Postal applications will not be accepted.
We will acknowledge receipt of your application by email.
5th August / Notification of long list
25th August / Long-listed applicants to notify Arkwright of examination results and provide a scanned copy of UCAS confirmation letter
2nd September / Notification of interview short list
Week of 11thto 15th September / Interviews for shortlisted candidates at the Arkwright Scholarships Trust’s office in Leamington Spa, Warwickshire
There is no opportunity to be interviewed on any other day. If you are not available on these dates, then you cannot be considered for a Scholarship.
Before submitting your application, please ensure you have provided all required documentation. We will not contact you for missing information and your application will be disadvantaged.