Application Form for Postgraduate Study

Application for Research Degree Study

Please TYPE your responses and return to

SECTION 1

Personal Details

Title Surname Date of Birth

(Mr/Mrs/Miss/Ms etc) Day Month Year

Forename (First Name) Previous Name(s), if changed Gender

Home AddressCorrespondence Address (if different)

Postcode: / Postcode:
Telephone: / Mobile:
E-Mail:

Country of Domicile: Nationality:

Are you of member of Leeds Trinity University staff?

SECTION 2

Research Programme Sought

Qualification Aim Subject area

e.g. PhD* / MPhil / Master by Research(Arts or Sciences)/GTA

Mode of study Proposed Date of Entry

Full-time or Part-time? Month Year

* Provisional registration only until Transfer Assessment Viva

SECTION 3

Higher Education and/or Professional Qualifications(in date order - most recent first)

You must enclose copies of your qualifications and any transcripts of results with this application.

University/
Institution / Dates
Start Finish / Qualification / Subject / Language of instruction (for course taken outside the UK) / Result / Date of Completion

SECTION 4

Provide further details of the content of your undergraduate degree programme or any previous postgraduate programmes.

SECTION 5

Is English your first/native language?YesNo

If English is not your first/native language you will be required to demonstrate competence through IELTS. Please forward evidence/certificate with this application if you have already completed IELTS.

If not yet completed, give test date below

IELTS score (certificate attached) Test Date

SECTION 6

Other Courses and Experience

Details of any other courses taken or other qualifications which are relevant to this application.

Date of Course / Title of Course / Qualifications obtained or to be taken
(give dates/grades)

Other information you consider relevant to your application (e.g. professional or vocational experience)

Have you applied to study at

Leeds Trinity University previously?To which department?

When?

SECTION 7

Employment History (most recent first)

Name and Address of Employer / Job Title / Dates
To From

SECTION 8

Present Situation

Please give a brief description of your current situation, i.e. a student (full or part time), employed (full or part time)

SECTION 9

Statement of Academic Research Interest

Please indicate why you are applying for this programme of study and give a brief description of the general research area in which you are interested. Candidates are advised, where possible to submit a specific research proposal. If you have done so, please tick the box and describe the project on a separate sheet of paper, if necessary. Please name your supervisors (if known).

SECTION 10 (for PHD/GTA applicants only)

Referees Name three people who will be providing references, at least two of whom should be qualified to comment on your educational background and potential for your chosen programme of study. Please use the reference request from provided for those referees. You should arrange for your referee to send the reference directly to the admissions team (failure to do so will hold up your application).

Name: / Name: / Name:
Occupation: / Occupation: / Occupation:
Address: / Address: / Address:
Telephone: / Telephone: / Telephone:
E-Mail: / E-mail: / E-Mail:

If you are not ordinarily resident in the United Kingdom, please indicate periods of residence in the United Kingdom prior to the course.

From / To / Purpose of Residence (e.g. education, employment, etc)

SECTION 11

Disabilities/Special Requirements

At Leeds Trinity we provide a wide range of additional support to address individual needs. Please let us know if you have a disability below.

We would be pleased to arrange an informal meeting with you to discuss any individual support requirements to enable you to participate in the course.

I have a disability or dyslexia and would like an informal meeting

I have a disability or dyslexia but do not require any additional support

If you would like to give any additional information to assist us in considering your additional support needs, please do so in the space below.

SECTION 12

Criminal Convictions Do you wish to declare any criminal convictions? If you are a serving prisoner, please supply the prison address in the box below.

Yes No

SECTION 13

Non European Economic Area (EEA) Applicants

Passport No. / Country of Birth
Your immigration history. Please complete as appropriate.
Have you ever been rejected/ refused or overstayed a UK visa or withdrawn by a UK institution? If yes, please provide the dates and reasons here:
Do you have a current UK visa? If yes, please provide us with your visa category, expiry date and the name and address of your current sponsor:
Have you ever studied in the UK previously? If yes, please provide details of the visa categories, the levels of programmes studied and the total length of study periods in the UK. Please also attach copies of your previous visa(s):

Declaration: I agree that if the information given on this form is later found to be false, Leeds Trinity University may withdraw any offer or subsequent place on the programme of study. I understand that this information will be used for the purposes of admissions and will form part of a subsequent student record if I am accepted. I give my consent to the processing of my data and to use it for statistical reporting that will not identify me. I confirm that the information given on this form is true, complete and accurate.

Date of completion

Signature of Applicant:

Day Month Year

Please send your completed application form with copies of degree (undergraduate and postgraduate) certificates and transcripts, copy of English language certificate, any letters of sponsorship and specific research proposal if available to:

Ensure that references are sent to admissions.

If you do not submit all required document this will delay processing of your application.

REFEREE’S REPORT

Confidential Reference for an Applicant for admission to study a Research Degree at Leeds Trinity University

Applicants should complete section A.

Referees should complete and endorse Sections B-C and return the reference by emailing to the Admissions Team at The reference should be submitted by the referee, not the applicant.

Section A: Applicant Details Section B: Referee Details

Family Name / Family Name
Other Name(s) / Other Name(s)
Title / Title
Programme of Study applied for / PhD - / How long have you known the Applicant?
Department applied to / In what capacity do you know the Applicant?
Academic institution in which you are/were employed
E-mail/telephone number

The Applicant named above has applied to study at Leeds Trinity University and has named you as a Referee. We would be most grateful if you could let us know confidentially whether in your opinion the Applicant possesses the necessary academic and personal qualities to undertake such a course.

In order to assist the Applicant in receiving a prompt decision about their application we would be grateful if you could return the reference as soon as possible.

Section C: Referee’s Assessment Form - How you would rate the applicant against each of the criteria listed below?

Excellent
(Student in top 5%) / Good
(Student in top 20%) / Satisfactory
(Student in top 50%) / Poor
(Student not in top 50%)
Quality of work
Academic potential
Reliability
Attendance/punctuality
IT skills
Verbal communication skills
Writing skills
Relationships/teamwork
In addition, it would be helpful if in the space below you could provide us with the following information, in as far as you are able:

The standard, actual or anticipated, of the applicant’s current/previous academic work
Your opinion and expectations of the applicant’s ability in research and writing
Your opinion of the suitability of the proposed field of study/research area for the applicant
Your opinion of the extent to which the applicant’s personal circumstances make them a suitable recipient of a Scholarship

Additional Comments

Please continue on a separate sheet if necessary

Signed………………………………………………………………………………………….. Date …………………………………………………………

FOR OFFICE USE ONLY

Admission Decision

(to be completed by research office)

Accept Notes (i.e. record
outcome of
interview etc)
Reject
Conditions (i.e. certs, reference etc)

Start Date Qualification and
Programme Title
Day Month Year

Signature of Admissions Tutor Date