School of Slavonic and East European Studies
Application Form: The SSEES Excellence Scholarship
Name: _______________________________________________________________________
Title of Thesis: _________________________________________________________________
_________________________________________________________________
Principal Supervisor:
___________________________________________________________
Second Supervisor:
___________________________________________________________
Start Date of MPhil/PhD:___________________
Part time / Full time delete as appropriate
Date of Upgrade: _________________________
Anticipated submission date______________
E-mail Address: ____________________________________________________________________
Correspondence Address:____________________________________________________________
____________________________________________________________
____________________________________________________________
Please give a summary of your academic background (starting with highest qualification sought or achieved,
including Institution’s name, subject of degree, degree classification, and attendance dates):
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Please list any awards, honours, or fellowships you have received (starting with the most recent, including
dates and amounts of any fellowship).
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Please list any invited talks (conferences or university seminar series):
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Please list any scholarly publications:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Please attach the following documents:
1. A summary of your research project (500 words), to include a timetable indicating chapters
completed to date (in draft or revised form), chapters not yet completed, and a projected date
of submission; and
2. A letter from your supervisor.
The information that I have given on this form is, to the best of my knowledge, accurate and
complete.
Signature_________________________________________
Date_____________________________________________