PGR Cop Appendix 13 Annexe 1

PGR CoP Appendix 13 Annexe 1

APPLICATION FORM FOR VISITING PGR RESEARCHSTUDENTS

Please consult UoL’s PGR Policy for Visiting Research Students before completing the format:

SECTION 1. PERSONALDETAILS
Title (Mr/Mrs/Msetc)
Family name or lastname
First or givenname
Middle or othernames
Date ofbirth
Gender
Nationality
Previous lastname
(ifapplicable)
Country ofbirth
Passportnumber
(for International Applicants: the Universitywillrequire this for you to apply for a studentvisa)
Passport issuedate
Passport expirydate
Passport country ofissue
Full address forcorrespondence: Line1
Line2 CityCountry
Postcode/zipcode
Telephone/mobilenumber
Email
Fax
Full permanentaddress: (if different fromabove) Line1
Line2 CityCountry
Postcode/zipcode
Telephone/mobilenumber
Email
Fax
SECTION 2. DETAILS OF PROPOSEDVISIT
In which School/Institute willyoubebased?
On what basis will you attend UoL? / □Supervised
□Unsupervised
Name of your proposed UoLSupervisor (only applicable to supervised VRS)
Briefdescriptionoftheproposedresearchproject(includingrequiredequipment and training)
Proposed start date(mm/yyyy)
Proposed end date(mm/yyyy)
SECTION3.VISAANDENGLISHLANGUAGE REQUIREMENTS
All students at UoL, both from the UK and overseas, are expected to have high proficiency in the English language, normally demonstrated by holding a satisfactory English language qualification. For fulldetailsoftheexternalrequirementsforanInternationalVRSattendingUoLpleaserefertothe
Policy referred to at the top of this form and to the UKVIwebsite.
English qualification (ifapplicable)
Score/grade
Date taken/to betaken
Are you already a VRS at another UK Higher Education Institution (HEI)?[1]
If so, at which UK HEI are you based?
SECTION 4. HOMEINSTITUTION
Home institution at which youare registered for your PGR award
Institutionaddress: Line1
Line2 CityCountry
Postcode/zipcode
Name of your AcademicSupervisor
Telephone number of your Supervisor
Email of yourSupervisor
Current PGR academicprogramme
Start date of currentprogramme
End date of currentprogramme
SECTION 5. DISABILITY/SPECIALNEEDS
Do you have adisability?
PleasealsocompletetheEqualOpportunitiesMonitoringformattached.Anyinformationgiven about disability will be treated inconfidence.
SECTION 6. CRIMINALCONVICTION
TohelptheUniversitytoreducetheriskofharmorinjurytoitsstudentscausedbythecriminalbehaviour of other students, we must know about any relevant criminal convictions thatan applicanthas.
Relevant criminal convictions are only those convictions for offences against the person,whether of aviolentorsexualnature,andconvictionsforoffencesinvolvingunlawfullysupplyingcontrolled drugs or substances where the conviction concerns commercial drug dealingor trafficking.
Convictions that are spent (as defined by the Rehabilitation of Offenders Act 1974) arenot considered to be relevant and you should not reveal them (but see below).
If you are applying for research in teaching, health, social work, veterinary science or areasinvolving workwithchildrenorvulnerableadults,youmusttellusaboutanycriminalconvictions,including spentsentencesandcautions(includingverbalcautions)andbind-overorders.Forthese,youmay need an ‘enhanced disclosure document’ from the Disclosure & Barring Service. More informationmay be foundontheDisclosure & Barring Servicewebsite.
Research in teaching, health, social work, veterinary science and other courses involving workwith children or vulnerableadults. You must answer YES if any of the following statements apply to you:
□ I have a criminalconviction.
□ I have a spent criminalconviction.
□ I have a caution (including a verbalcaution).
□ I have a bind-overorder.
□ I am serving a prisonsentence.
Do you have a relevant criminalconviction?
Ifyouare currentlyservingaprisonsentence,youmust alsogivetheprisonaddressasyourpostal addressonpage 1ofyourapplicationandaseniorprisonofficermust supportyourapplication.
SECTION7.CHECKLISTANDDECLARATION
Youmust enclosethe following requireddocuments withthisapplication:
□ Confirmationof yourregistrationatyourcurrenthomeinstitution
□ A letter from your home institution permitting you to spend the specified period of time at the University of Liverpool as a visiting research student.
□ Two academic references
□ Copiesof EnglishLanguageCertificates(asappropriate)
Please tick the above boxes to confirm that you have enclosed these documents with your application
I certifythattheinformationcontainedwithinthis application is trueand accuratetothebestofmy knowledge.
IagreetotheUniversityprocessingpersonaldatacontainedinthisformorotherdatawhichthe University mayobtain from me orother sources. I agree to the processing of such data for any purpose connected with my studies or my health, welfare and safety, or for any other legitimate reason.
Pleasenote,visiting researchstudents areliable topaya registrationfeeandresearchsupportfee. Formoreinformation, pleasecontacttherelevantinstitute/school/department.
NB. For electronic applications please type your full name in to the signature box: this willbe accepted asanelectronicsignature.
Signed
Date
Pleaseensureyou havesigned and datedtheform beforereturningtothe PostgraduateAdministrationTeamintheSchool/Institute. Applications receivedwithouta signaturewillnotbe processed.
Completedapplicationsshould besubmittedeither byemail or posttothe School/Institute.
Contact details will be provided on the School/Institute’s website or by their PGRAdministration team.

Inorderforustomonitorequalopportunities,wewouldappreciateitifyoucouldanswerthefollowingquestions.

1.Ethnic origin

Pleaseselecttheoption(seebelow)thatyoufeelbestdescribesyourethnicorigin.

White – British10White – Irish10White – Scottish10
Other white background10
Black or Black British – Caribbean21Black or Black British – African22Other Black background29
Other Ethnic background80
Asian or Asian British – Pakistani32AsianorAsianBritish–Bangladeshi33 / Chinese34
Other Asian background39Irish Traveller14
Mixed – White and Black Caribbean41Mixed – White and Black African42Mixed – White and Asian43
Other Mixed background49Asian or Asian British – Indian31Not known90
Information refused98

Ifyouhaveusedthecodefor‘OtherBlack’,‘OtherAsian’,‘OtherMixed’or‘OtherEthnicbackground’, please provide further information here:

2.Disability

Intheapplicationformwehaveaskedaboutthenatureofanydisabilityinorderthatwecanprovidethebestavailable support. For planning purposes we would appreciate it if you could identify themost appropriatedescriptiontodescribeyourdisabilityusingthelistbelow:

Disabilities/supportrequired

0Youdonothaveadisabilityorarenotawareofanyadditionalsupportrequirementsinstudy oraccommodation.

1Youhaveaspecificlearningdifficulty(e.g.dyslexia).2 You are blind/partiallysighted.

3You are deaf/hard ofhearing.

4Youareawheelchairuser/havemobilitydifficulties.5 You have mental healthdifficulties.

6Youhaveanunseendisability,e.g.diabetes,epilepsy,oraheartcondition.7Youhavetwoormoreoftheabovedifficulties/specialneeds.

8 You have a disability, special need or medical condition notlisted above.

Ifyouwouldliketodiscusssupport,accessandfacilitiesfordisabledpeople,pleasecontact:TheDisabilitySupportTeam,StudentSupportServices,StudentServicesCentre,150MountPleasant,TheUniversityofLiverpool, L69 3GD,UK

Telephone:+44(0)1517944714orFax:+44(0)1517944718 Email:

Minicom: +44 (0) 151 7944713

[1]AnexistingVRSinanotherUKHEImustcheckthevisarequirementsfortheireligibilitytoapplytoUoL