Postgraduate
Application Form
The completed form may be returned by post, fax or sent as an e-mail attachment to the Faculty Office - Please follow
the link from the on-line postgraduate prospectus to 'Contact Details'.
1. I wish to apply to the Faculty of :2. Department of :Previous Study at Bristol : Are you currently (or have you been) a student at this
University.
(Please supply information on your previous registration in Section F)
Yes / No
3. Proposed Area(s) of Study
By advanced taught programme (Certificate/Diploma/Master).
Please state name of programme below.
Yes / No
By Research: please attach either a research proposal giving research area in
sufficient detail to allow research topic and methodology to be assessed or a list of
areas of research interest.
Masters Degree
Yes / No
Ph.D.
Yes / No
Other (please specify) e.g. MD
Yes / No
Section A
Personal Information
4. Surname / Family Name
(block letters):
5. First Names (s)
6. Date of Birth
7. Country of Birth
Country of Permanent
Residence
8. Home Address
Title:
(Mr / Mrs / Ms / Miss)
Marital Status
Nationality
Since
Telephone
E-mail
Address for
Correspondence
(if different from home)
Fax
Mobile Telephone
Are you registered disabled?
Nature of disability
Fax
Yes / No
Start date and method of study
Starting date
Method of study
Month
Full time
Yes / No
Year
Part time
Yes / No
Section B
Finance
Proposed means of financial support
Name and address of person
or organisation responsible
for paying fees (if not
yourself)
Is finance provisional or confirmed?
Section C
Qualifications
already obtained (or expected)
Degrees and Professional Qualifications
Title of Qualification Conferring institution
Dates of Study
Class/Division/Grading
Please forward a transcript (officially translated if not in English) of your degree results.
Work Experience
Please indicate details of your recent principal appointments (you may provide a Curriculum Vitae instead
if you wish)
Name / Organisation
Dates
Post Held
Section D
English Language Proficiency
Is English your first language?
If English is not your first language or if the medium of
instruction at your previous University was not
English, please give details of any relevant
qualifications in English language (e.g. IELTS date and
score). Please forward copies of certificates for
TOEFL or IELTS tests already taken. Please note
IELTS is preferred.
Section E
Yes / No
Names and Addresses of Referees
Please supply references using the standard form available on our web site. These must be completed and
signed by the referee please (e-mail attachments will not be accepted).
First Referee Second Referee -
Section F
Other Information
Previous Contact with the University
If you have already contacted any member of the University about your application, give his or her name
and department.
Previous Registration / Member of the University of Bristol
If you are currently (or have you been) studying at the University please supply information on your
programme of study, year of graduation and student number, if possible.
If you are a member of the University of Bristol or have academic status within the University of Bristol,
please state in what category (academic/academic related/technical/other) and give title of appointment
Other Applications
Please state which other Universities in the United Kingdom, if any, you have applied to for
postgraduate study; please indicate the area of research/taught programme applied for.
Additional Information
If you wish to give additional information please use this section
Source of Information
Where did you find out about opportunities for postgraduate study in the University of Bristol
Name
Date of
Application
All decisions by the University are taken in good faith on the basis of the statements made on your application
form. If the University discovers that you have made a false statement or have omitted significant information
on your application form, for example in examination results, it may withdraw or amend its offer, or terminate
your registration, according to the circumstances. The information given on this application form will be
electronically stored and used for administrative purposes by the University in accordance with the provisions of
the Data Protection Acts 1984 and 1998.
FOR THE UNIVERSITY'S USE ONLY
To the Department considering the above application:
Please indicate below your decision on this candidate, together with any conditions required if an offer is recommended.
NAME OF CANDIDATE:
ACCEPT for (Qualification title):
Qualification aimed for:
ADVISER:
STARTING DATE:
MINIMUM PERIOD OF STUDY
State whether full-time or part-time
SUBJECT OF STUDY/PROPOSED TITLE OF RESEARCH:
CONDITIONS:
REJECT
Please give reasons for rejection:
Signed …………………………………………………….
Date ……………………………..
Signed ……………………………………………………
Head(s) of Department/Representative(s)
Date ……………………………..
For Faculty Use
Approved by………………………………………………
Board/Committee/appropriate Officer, etc.
Date………………………………