UNIVERSITY COLLEGE CORK

COLLEGE OF ARTS, CELTIC STUDIES AND SOCIAL SCIENCES

Boole International Doctoral Scholarships

in the Humanities and Social Sciences

APPLICATION FORM

Please consult the Terms and Conditions of the Scheme and complete this application form in accordance with the instructions. Applications should be typed, not handwritten. The completed application form must be emailedto

Important Notes

  • Incomplete applications will not be considered.
  • Hard copy applications will not be accepted, including those sent bypost or fax.
  • All applications will be acknowledged by email within ten working days.

1. APPLICANT NAME:

2. PAC APPLICATION NUMBER[*]:

3. UCC STUDENT NUMBER [where applicable]:

4. DEPARTMENT/SCHOOL IN UCC WHERE YOURRESEARCH WILL BE CARRIED OUT:

5. NAME OF YOUR RESEARCH SUPERVISOR IN UCC:

6. WHEN DO YOU INTEND TO START YOUR PHD/PHD TRACK/MPHIL AT UCC?

[Month, Year]:

6. POSTAL ADDRESS:

7. DATE OF BIRTH:

8. E-MAIL ADDRESS:

9. TELEPHONE:

10. UNDERGRADUATE CAREER

(including details of any qualifying examinations to enter postgraduate studies)

Name of Institution(s)
Attended: / Years Registered
From:
To: / Title of Qualification(s): / Subjects: / Awarding
Institution(s): / Level/
Class/
Grade: / Date
Conferred:

11. POSTGRADUATE CAREER: DEGREES/DIPLOMAS

Name of Institutions(s)
Attended: / Years Registered
From:
To: / Title of Qualification(s): / Subjects: / Awarding
Institution(s): / Level/
Class/
Grade: / Date Conferred:

12. PLEASE LIST ANY GRANTS/SCHOLARSHIPS ALREADY AWARDED TOWARDS YOUR DOCTORAL STUDIES,INCLUDINGANY YOU HAVE APPLIED FOR WHERE THE OUTCOME IS STILL UNKNOWN. PLEASE NAME THE AMOUNT AND SOURCE OF EACH AWARD.

(Failure to disclose such awards will result in disqualification)

13. OTHER RELEVANT ACADEMIC OR PERSONAL DETAILS:

14. RESEARCH PROJECT TITLE:

15. Please state HOW/where you HEARD out about this Scholarship:

DECLARATION BY APPLICANT

I declare that the above particulars are correct and understand that the circulated “Terms and Conditions” of this scheme apply. I accept that failure to abide by the “Terms and Conditions” may disqualify me from this scheme.

Signature of Applicant: Date:

Important Notes:

  • Incomplete applications will not be considered.
  • Hard copy applications will not be accepted, including those sent by post or fax.
  • All applications will be acknowledged by email within 10 working days.

Page 1 of 3

Boole International Doctoral Scholarship

Application Form

[*]You MUST include a PAC application number. You will receive this number when you have applied for your PhD/PhD Track/MPhil on .