Postgradaute Research Degree Applicaiton Form

PROFESSIONAL DOCTORATE APPLICATION FORM

Please complete this form in BLOCK LETTERS with a black pen or in typescript. Guidance Notes are provided at the end of this form.

* Delete whichever is not applicable.

A signed paper copy of the completed form shouldbe returned to:

The Graduate School, University of Chester, Parkgate Road, Chester, CH1 4BJ

1. PERSONAL DETAILS
Mr/Mrs/Miss/Ms/Dr/Other
(specify)* / Forename(s) / Last name (family name, surname)
Date of Birth DD/MM/YY / Nationality / Male/Female*
Address for correspondence:
Postcode:
Telephone Number:
Email address: / Permanent address (if different):
Postcode:
Telephone number:
Email address:
Have you lived in the UK/EU for the whole of your life up to the present day?
Yes [ ] No [ ]
2. REGISTRATION
Final degree aimed for:
Doctor of Ministry (MATTERSEY HALL) [ ]
Full time [ ] Part time [ ]
Proposed start date

3. PREVIOUS STUDY /QUALIFICATIONS

See Guidance Notes.

3A PREVIOUS STUDY AT CHESTER

If you have previously studied at University of Chester please state your registration number, if known, and the course(s) studied. If you have changed your name since you were a student please indicate the name by which you were previously known at the institution.

3BUNIVERSITY QUALIFICATIONS ACHIEVED / EXPECTED

Please attach official transcripts of academic record (degree certificates, professional certificates etc).

(i) University / Institution attended

Degree Title

Class or Grade e.g.GPAYear of Award

Full time / part time *.Dates of Attendance

Subject(s)

(ii) University / Institution attended.

Degree Title

Class or Grade e.g.GPAYear of Award

Full time / part time *. Dates of Attendance

Subject(s)

3C PROFESSIONAL QUALIFICATIONS

Please provide details, including type of qualification, subject, grade and date.

3DPREVIOUS RESEARCH DEGREE STUDY

Have you made any previous applications or undertaken research degree study at another institution?YES/NO*

If YES, please provide details.

3EENGLISH LANGUAGE QUALIFICATIONS

What is your first language?

If English is not your first language, please give details of your English Language qualifications, including grade, class, awarding body and date awarded or expected.

IELTSScoreDate taken / to be taken

TOEFLScoreDate taken / to be taken

Other (please specify)

ScoreDate taken / to be taken

Please attach an official copy of your English Language certificate (where appropriate).

4. OTHER RELEVANT SKILLS AND EXPERIENCE

Please give details of other relevant skills and experience which may be relevant to your studies, for example, full-time

employment, teaching or research experience, foreign language ability, information technology skills, driving licence.

5. DISABILITY/SPECIFIC NEEDS*

[ ] A– None[ ] F - Mental health difficulties

[ ] B–Aspergers[ ] G – Dyslexia

[ ] C - Blind/Partially sighted[ ] H - Wheelchair user

[ ] D - Deaf/Hard of hearing[ ] I - Other disability - Please state……………..………………………

[ ] E - Unseen disability - Please state[ ] J - Multiple disabilities – Please state

……………..……………………………………………..……………………………………………………

*If you have ticked any of the above, please provide details of your requirements for interview and/or study purposes. If not applicable, please state N/A.

6. REFERENCES

(Please give the details of two persons whom you have approached to be your referees. It is your responsibility to approach your referees and ensure that they return the forms to us. Please tick to indicate you have done this. See Guidance Notes)

1.Name:

Position:

Name of Institution:

Address:

E-Mail:

2. Name:

Position:

Name of Institution:

Address:

E-Mail:

7. CURRENT OCCUPATION AND PERSONAL STATEMENT

Current Employer:

Current Post:

Please explain why you wish to undertake a Professional Doctorate and how it relates to your current role and your career /

academic objectives. You may reply on a separate sheet if you prefer.

Please provide anbroad outline of your proposed research project indicating the general field in which you will be conducting

your research.

8. FINANCIAL SUPPORT

Please attach copies of your sponsorship /scholarship letter or financial statement where appropriate. See Guidance Notes.

(i) Please state how you intend to finance your studies at Chester (e.g. sponsorship, self-funding)

(ii) Have you applied for a sponsorship / scholarship?Yes/No*

(iii) If yes, please give details, including dates

(iv) Have you already been awarded a sponsorship / scholarship?Yes/No*

(v) If yes, please give details, including dates

(vi) What will this sponsorship / scholarship cover? (e.g. tuition fees, maintenance)

9. PUBLICITY

How did you first learn about postgraduate research at University of Chester? Please tick one box.

[ ]UniversityProspectus

[ ]Departmental Advisor / Supervisor / Careers Advisor

[ ]British Council Office (please indicate location):

[ ]Education Exhibition / Careers Fair (please indicate venue)

[ ]Internet

[ ]Professional journal / other publication (please specify)

[ ]Alumni

[ ]Friends / Relative

[ ]Other (please specify)

10. OTHER APPLICATIONS

Please state which other UK universities you have applied to. This information will not be used as part of the selection process

and will remain confidential.

11. CRIMINAL CONVICTIONS
See Guidance Notes.
Do you have any criminal convictions? (Please tick appropriate box) YES [ ] NO [ ]
If you have answered “Yes” to this question, please ensure that you attach a note to this application form describing the nature and date of the conviction and the consequences of that conviction in terms of sentence served or caution received. N.B. If you do not answer this question, we cannot process your application. See the guidance notes for more information.
12. ACADEMIC, PROFESSIONAL AND RESEARCH MALPRACTICE
Have you ever been found guilty of academic, professional or research malpractice?
Yes No
If you have answered “Yes” to this question, you will be required to provide further details.

13. CHECKLIST

I enclose the following documents with this form (tick as appropriate)

[ ]Evidence of academic or professional qualifications (including transcripts where necessary)

[ ]Copies of English Language certificates (where appropriate)

[ ]Copy of Curriculum Vitae

[ ]Sponsorship / scholarship letter / financial statement (where appropriate)

[ ]Other relevant items (please specify)

14. DECLARATION:
I understand that I am responsible for payment of all tuition fees. I agree to comply with the statutes, ordinances, bye-laws, regulations, rules and conditions of the University of Chester for the time being in force, including Health, Safety and Disciplinary Regulations. I agree that all ideas, materials or work produced by me and submitted as part of the requirements of my programme of study and all intellectual property rights therein will become the absolute property of the University of Chester, unless specifically agreed to the contrary.
Data Protection Act 1998
I consent to the University of Chester processing personal data contained in this form, or other data which may be obtained from me or others, including details of academic performance, learning support needs, disciplinary matters, destinations and comments on quality, closed circuit TV and video recording on university premises and holding my photograph which is used on the student ID card for any purpose connected with my studies, my health and safety, implementation of the Rules, to provide data that the University is required to hold or supply to the Higher Education Statistics Agency (HESA) or for any other legitimate reason. I consent to the disclosure of such information for academic administration purposes, in response to requests for references relating to continuing education, training or employment, for implementation of the Rules or in relation to council tax matters. I understand that HESA pass data to organisations that need it to carry out their statutory functions connected with funding higher education. I am aware that I may request a copy of information held about me on request and on payment of the appropriate fee and that further information regarding HESA can be found on Sharepoint.
By checking the box, I hereby agree to this declaration:
I Agree
Check the box and TYPE your full name in the box below (failure to do so will result in your form NOT being processed).
Full Name:

15. Official use only

Date application received in MATTERSEY HALL: ......

Date of Interview: …………………………

Recommended Decision: Accept [ ]Reject [ ]

If Accept, conditions of offer (if any): ......

If Reject, reasons for rejection: ......

Signature of Partnership Programme Leader ……………………………………………………………………………………………..

Date application received in TRS……………………………………………………………………………………………..

Recommended decision:Accept [ ]Reject [ ]

Comments ……………………………………………………………………………………………………………………………………..

Date received in Graduate School ………………………………………………………………………………………………………….

Decision:Accept [ ]Reject [ ]

Date offer letter sent/authorised (delete as appropriate) …………………………………………………………………………………

Comments ……………………………………………………………………………………………………………………………………..

GUIDANCE NOTES FOR COMPLETION OF THE PROFESSIONAL DOCTORATE APPLICATION FORM

These notes are intended to help you complete the application form, and to ensure that, once completed, your application may be processed as efficiently as possible. The application shouldbe returned to the address printed on page 1 of the application form.

Section 3: Previous Study / Qualifications

3B University Qualifications Achieved / Expected

University / Institution attended: International students should give the name of the institution and the country in which your institution is located.

Degree title: indicate here the type of award you studied for e.g. BA, BSc, MA etc.

Class or Grade: Give the grades you attained and indicate the system of assessment used, e.g. degree class, grade point average (GPA) percentile rank, numerical or alphanumerical scale (indicate the minimum and maximum scores) etc.

Year of Award: If you have not yet achieved your award please indicate when you expect to receive the results.

Subject(s): Please give your major subject area. Please also give an indication of the other subjects studied.

3C Professional Qualifications: List here any non-academic qualifications you hold.

3D Previous Research Degree Study: If you have previously undertaken postgraduate research study at another HEI please provide details about the study and whether you successfully completed the course. Reasons for not completing the course should be given if appropriate.

3E English Language Qualifications: If English is not your first language, you will have to produce documentary evidence of your English language ability.

Section 5: Health

This section is included for the purposes of monitoring equal opportunities and to ensure the University can provide students with appropriate facilities. It will not affect the University’s decision whether or not to offer you a place and the information remains strictly confidential.

Section 6: Referees

You must provide the names and addresses of two referees who have agreed to act on your behalf. It is your responsibility to approach your referees and ensure that they return the forms to the Graduate School. Your referees must have recent experience of your knowledge and expertise.

Section 8: Financial Support

Please give as much detail as possible about your known or anticipated funding arrangements. If you are an international student you should note that you will have to demonstrate to the Immigration Officer when you enter the UK that you have sufficient funds to pay for your fees and support yourself throughout the course.

Section 11: Criminal Convictions

To help the University reduce the risk of harm or injury to its students caused by the criminal behaviour of other students, we must know about any relevant criminal convictions that an applicant has. Please provide brief information here.

Relevant criminal convictions are only those convictions for offences against the person, whether of a violent or sexual nature, and convictions for offences involving unlawfully supplying controlled drugs or substances where the conviction concerns commercial drug dealing or trafficking.

Convictions that are spent (as defined by the Rehabilitation of Offenders Act 1974) are not considered to be relevant and you should not reveal them.

Please note that some programmes require you to apply for a Criminal Records Bureau check. You will be contacted with further information where appropriate.

Section 13: Checklist

Please ensure that your application consists of:

This completed application
Copies of Transcripts/certificates
Curriculum vitae (please include a CV if it includes additional relevant information not provided on the application form)
Copies of English Language certificates (where appropriate)
Sponsorship/scholarship letter/financial statement (where appropriate)