Application for Admission to Research Higher Degree Candidature and Scholarship (SUTS)

Sarawak Campus
Application for Admission to Research
Higher Degree Candidature and Scholarship (SUTS)

WHO SHOULD COMPLETE THIS FORM?
This form should be used when applying for candidature in a Doctor of Philosophy or Masters by Research program. This form is also used to apply for scholarships for research programs.
APPLICANT’S GUIDE TO COMPLETING THIS FORM
Step 1: This is form is to be filled and submitted electronically (filename: w_ applicatn_x_y_z .doc all in lowercase where W = the award (phd or masters); X,Y Z are your forename(s) and surname). Complete all questions, sign and date the application form.
· Please use BLOCK LETTERS where applicable.
· Please tick R the appropriate boxes.
· Complete all sections and sign the declaration on page 5. Scanned images of signatures added to this document are accepted.
Step 2: Ensure that you attach certified copies of all university results or transcripts, graduation certificates and proof of name and citizenship
· Certified documents must be signed by an authorised person (refer to ‘Should I provide supporting documentation’) and must include an original signature, the name, address and title of the person signing, and an appropriate registration number. Photocopies of previously certified documents are not acceptable.
Step 3: Ensure that you attach a current curriculum vitae.
Step 4: Applicants should note that:
· The Research Higher Degrees Committee will only consider those applications that are supported by a supervisor and Faculty. You should consult with your proposed supervisor(s) prior to completing this form.
· Further information about the application process and additional copies of this form are located at http://www.swinburne.edu.my/research/home/viewPage/10
· Failure to follow the instructions given will delay an outcome of your application.
Step 5: Return the completed form and all supporting documentation to:
Your intended Coordinating Supervisor who will then be responsible for passing the application through the various stages required.
SHOULD I PROVIDE SUPPORTING DOCUMENTATION? (INFORMATION FOR APPLICANTS)
· Copies of supporting documentation will be required by Swinburne University of Technology depending on your response to Section C: Questions 2, 7 & 11b, Section D: Questions 1, 2 & 3 and Section F: Question 1. Supporting documentation must be certified as a true and correct copy of the original by either the issuing body or by those people qualified to accept a statutory declaration (e.g. police, chemists, doctors, accountants).
· Do not submit original documents.
· Please provide translations of supporting documentation if original documents are in a language other than English.
Applicants who have obtained an IELTS (International English Language Testing System) result in the last 2 years:
· Attach a certified copy of the test results certificate with grading systems.
· If language proficiency is not at the appropriate level you may be offered a candidature that is conditional on you successfully completing an English language program.
· Candidates will not be made an offer of candidature unless evidence of English language proficiency has been provided or participation in an appropriate program has been agreed upon.
Applicants who have obtained an award outside Australia must submit:
· Evidence of completion of the relevant award, ie: award certificate or letter of completion.
· Transcript/s of examination results.
· Evidence of English language competence, ie: certified copy of IELTS test results certificate or evidence that study was undertaken in English.
WHAT WILL HAPPEN AFTER I LODGE MY APPLICATION FORM?

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· A University staff member will contact you if you are required to participate in an interview or provide additional information to support your application.
· All applicants will be acknowledged and advised on the outcome of their application. RM
DO NOT INCLUDE THIS INSTRUCTION SHEET WITH YOUR APPLICATION
(delete this page)

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Application for Admission to Research Higher Degree Candidature and Scholarship (SUTS)

SECTION A: PROPOSED STUDY PROGRAM
1. Which research program are you applying for?
Program Code
(for RCFP use only) / NEC & Sub_NEC Program Code (for SUTS students only). Please refer to
Appendices A & B. / Program Name
e.g. Doctor of Philosophy; MEng; MSc; MBus. / Study Mode
(Full-time or Part-time) / Intended
commencement
Month / Year
NEC / Sub-NEC

Please note:

· The actual start date is the day on which you enrol.

· International students should allow six months for the processing of their visa application.

Checkboxes are provided for the answers to some questions that follow.

Double-click on the appropriate box and change the default value “not checked” or “checked” to indicate your answer.

For other questions insert your answers within the text fields (colored in grey) provided.

SECTION B: CURRENT / PREVIOUS RELATIONSHIP WITH SWINBURNE
1. Are you currently enrolled in a program at Swinburne University / TAFE? Yes No
If yes, please state / (a) Swinburne student ID number:
(b) Program name:
2. Have you applied or enrolled in a program at Swinburne University / TAFE previously? Yes No (proceed to Section C)
If yes, please state / (a) Swinburne student ID number:
(b) Program name:
(c) Last year of study at Swinburne:
3. Are you a Swinburne staff member? Yes No
4. Have you previously been excluded from a program at Swinburne or any other University? Yes No
If yes, please attach details
SECTION C: PERSONAL DETAILS
1. Current Name
Title (Mr, Mrs, Ms, Miss):
Family name/surname:
First given name:
Second given name:
Third given name:
2. Previous Name/s
Provide your previous name in full if your current name is different to that shown on supporting documentation or a previous enrolment at Swinburne. You must complete all fields (i.e. family name/surname/, first and second given names).
You must attach evidence of your change of name (e.g. marriage certificate, deed poll certificate) to this application.
Family name/surname:
First given name:
Second given name:
Third given name:
3. (a) Date of Birth (dd/mm/yyyy) / / / (b) Gender / Female / Male

4. Contact details

Email address: / Preferred Daytime Contact Number:
Mobile phone number: / Home Phone Number:

5. Postal Address

Number / street / city:
State: / Postcode:
Country:

6. Home Address

Same as above (Please tick) Yes – (if Yes, proceed to Q7) No – (complete details below)

Number / street / city:
State: / Postcode:
Country:
7. Citizenship
(a) Please tick one of the following. Refer to table below and attach the required supporting documentation
Australian citizen (includes Australian citizens with dual citizenships)
New Zealand citizen (includes those with Australian permanent residence status)
Holder of an Australian permanent resident visa or humanitarian visa (excludes those who have New Zealand citizenship) – go to Q7(b)
Holder of a citizenship other than Australian or New Zealand citizenship – please state citizenship
(b) If you are a holder of an Australian permanent resident visa or humanitarian visa, please state your visa sub-class number (from passport) and state type of visa (if known)
Supporting documentation as specified below is required to be attached if you have checked any of the boxes above.
Citizenship status / Certified copy of the following: / Certified copy must include:
Australian citizen / Birth certificate or Passport or
Certificate of Australian citizenship / Proof of full name
New Zealand citizen / Passport / Proof of full name; Proof of citizenship
Holder of an Australian permanent
residence or humanitarian visa / Passport / Proof of full name; Permanent resident or humanitarian visa showing Visa Sub-Class Number
Holder of a citizenship other than
Australian or New Zealand / Passport / Proof of full name; Proof of citizenship

8. Are you of Australian Aboriginal or Torres Strait Islander descent?

No Yes, Aboriginal descent Yes, Torres Strait Islander descent Yes, Aboriginal and Torres Strait Islander descent

9. Were you born in Australia? Yes (proceed to Q11) No, I was born in

10. Year of arrival in Australia

11. (a) Is English your first language? Yes No, my first language is

(b) If No, have you sat and obtained an IELTS (International English Language Testing System) result in the last two years with an average of at least 6.5 with no individual band less than 6?

Yes (please attach a certified copy of the test results certificate with grading systems) No

If ‘Yes’, please provide details and supporting evidence (attach documents if necessary)

12. Do you have a disability, impairment or long term medical condition?

(Providing information about a disability will not disadvantage your application. The information is needed for statistical and planning purposes, and to ensure that the University provides appropriate support services to students).

No (proceed to Section D) / Yes – (please tick one or more of the following):
Hearing / Visual / Mobility / Learning / Medical / Other
Would you like to receive advice or disability support services which may assist you during your studies?
Yes / No
SECTION D: SCHOLARSHIPS

1. (a) Have you been awarded a scholarship to undertake your research?

Yes No

(b) If yes, what scholarship have you have been awarded?

2. Applying for an SUTS scholarship (the SUTS Postgraduate Research Studentship)

If you are already enrolled as a postgraduate, please contact the Research & Consultancy Office.
Do you wish to be considered for an SUTS Postgraduate Research Studentship?
Yes No
If not, your application will be considered as soon as possible.
If you apply for a scholarship, your application will only be considered during one of the two annual scholarship rounds (around March and October). It is your responsibility to ensure that referee reports are forwarded to your referees and returned in time to be considered during the scholarship round.
Your scholarship application will only be considered if all the required documents are provided.
Scholarships are normally awarded only for full-time study.

If you are unsuccessful in obtaining an SUTS Postgraduate Research Studentship, you will be asked if you wish to enroll as a full-fee-paying candidate.

3. Referee reports

In addition to nomination of referees in Section G, you must send a copy of the full referee report form available on the web at http://www.swinburne.edu.my/research/home/viewPage/10

to each of your referees for completion and submission at the same time as this application. Please request your referees to only send their reports AFTER
your application has reached the Research Consultancy & Future Projects Office.

SECTION E: EXTERNALLY SUPPORTED RESEARCH

Will your research be supported by an organisation external to Swinburne? (e.g. APAI, CRC, Industry Scholarship)

Yes No (proceed to Section F)

If yes, have you signed a ‘Deed of Assignment’?

Yes No

If you have not signed a 'Deed of Assignment' you may be required to do so prior to commencing your project. The Deed of Assignment is a formal contract between the candidate and the University and is tied to the formal contract between the University and the funding body that covers issues pertaining to the ownership of Intellectual Property. Where an external body that is providing funds for the research holds a contract with the University you are not permitted to commence your candidature until you and the University have signed a 'Deed of Assignment'. For further information please check with your proposed coordinating supervisor. The University's Intellectual Property Policy is available at

http://www.swinburne.edu.au/policies-regulations/policies/people-culture-integrity/intellectual-property/

SECTION F: EDUCATIONAL HISTORY

You must submit the following documents:
(a) certified copies of all transcripts of results
(refer to “Should I provide supporting documentation” notes on cover page of this application form);
and
(b) proof of the completion of academic qualifications
1. POST-SECONDARY EDUCATION
List any studies you have completed or attempted at university, TAFE or other post-secondary institution.
Year
ended / Institution / Title of Program / Program Type* / Completed
Yes / No / Honours
Level e.g.
H1, H2A

*Program Types

Higher Education

PG: Higher Degree, e.g. PhD, Professional Doctorate, Masters, Post. Grad Diploma/Certificate BD: Bachelor Degree (Pass/Honours) OL: Open Learning

DP: Diploma from a University, C.A.E. or Teachers College (not TAFE) NA: Continuing Education/Single Subjects

TAFE Qualifications

CF: Certificate IV CD: Diploma CA: Advanced Diploma CE: Certificate III OC: Apprenticeship, Trade Certificate CS: Other TAFE Awards

Other Qualifications

NS: Hospital Based Nursing OB: Short Courses OA: Other Academic Award

2. Did any of the completed degrees/diplomas above include a research component? Yes No
If yes, / (a) What percentage of the degree was research? Please provide evidence
(b) Please provide a brief summary of that research (attach further documentation if required):
3. (a) Have you undertaken any additional research work or has any of your work been published? Yes No
(b) If yes, please list: (attach further documentation if required)
4. Are you transferring from another Australian university or have you previously been enrolled in a research degree at another Australian university? Yes No
If yes, / (a) Name of university:
(b) What was your candidature commencement date? // (dd/mm/yyyy)
(c) Have you withdrawn/completed your candidature? / Yes Date of completion/withdrawal // (dd/mm/yyyy)
No

SECTION G: REFEREES

Please provide details of at least two (2) people to whom confidential reference may be made by Swinburne. These people should have current professional knowledge of your academic ability and be able to judge your research potential. In an application for PhD candidature, one of these referees must be external to Swinburne.

Referee One / Referee Two
Name
Position
Address
Daytime Telephone
Email Address

SECTION H: RELEVANT EMPLOYMENT HISTORY AND/OR RESEARCH EXPERIENCE

Start date / End date / Employer / Nature of work / Full-time (FT) or Part-time (PT)

SECTION I: PROGRAM OF RESEARCH

1. What is the topic of your proposed research?

2. Please provide a brief description of your project (approximately 100 – 200 words). As a guide the description may include: background of the research problem, objectives, and the contribution to new knowledge (novelty) that this project will potentially make.