Fieldwork Approval form 2013-2014 SEED

advertisement
Faculty of Humanities
School of Environment, Education and Development
PGR FIELDWORK APPROVAL FORM
This form is issued by the School of Environment, Education and Development and should be used to apply to the PGR Committee for approval of any
periods of fieldwork or research that will be conducted away from the University, as defined in the PGR Handbook. All information contained in this
form will be treated as strictly confidential. You must read the School’s policy and guidance on PGR fieldwork approval prior to completing this form.
Once completed, this form and any supporting documentation should be returned to your School Administrator, via the
relevant PGR Office, pgr-seed@manchester.ac.uk
SECTION 1:
CANDIDATE DETAILS
Surname
ID Number
Forename
Year of Study
Full Time
Architecture
Geography
IDPM
Planning
Part Time
Supervisory
Team
Next of Kin
You should include the
relationship to you, address
and contact telephone
number of your next of kin.
SECTION 2:
PROPOSED FIELDWORK
Commencement Date
dd/mm/yyyy
Return Date
dd/mm/yyyy
Please note – if you are requesting to be on fieldwork for more than 6 months you must provide an academic case
outlining justification for the proposed timeframe.
Country of Fieldwork
City/Area of Fieldwork
Nature of Fieldwork
Fieldwork contact address
Please note – if you do not know this information
yet you MUST provide this before leaving for your
fieldwork. You must also input these details
through Student Self-Service with address
category as ‘Placement’
www.portal.manchester.ac.uk
Fieldwork contact telephone
number
For fieldwork outside of the United Kingdom:
Passport Issuing Country
Passport Expiry Date
1 of 3
If your passport is due to expire whilst you are away on
fieldwork, have you re-applied to the issuing authority?
Yes
No*
*Please explain why
SECTION 3:
ETHICAL APPROVAL
If your research requires ethical approval you must be granted this prior to the commencement of
your fieldwork. You will not be permitted to undertake fieldwork until ethical clearance has been
granted. Please cross one of the following boxes.
I confirm that I have applied to the School for ethical approval and it has been granted (please
provide email or letter confirming this from SEAG/UREC)
I confirm that I have applied to the School for ethical approval and I am still awaiting full ethical
clearance
I have not applied to the School for ethical approval*
*Please explain why
SECTION 4:
RISK ASSESSMENT
All students undertaking a period of fieldwork must complete an appropriate risk assessment and this
must be submitted with this form. Please cross one of the following boxes.
I confirm that the fieldwork conforms with the School Generic Risk Assessment for off-campus
working in the UK and attach a full itinerary
I confirm that the fieldwork conforms with the School Generic Risk Assessment for off-campus
working overseas and attach a full itinerary
I have completed a Full Risk Assessment for my research and have attached a full itinerary
SECTION 5:
FUNDING/SPONSORSHIP
Record any scholarships and/or funding sources you are in receipt of below. If you are sponsored by
an external organisation it is your responsibility to inform them and gain approval for your proposed
period of fieldwork. A letter confirming approval should be submitted with this form.
SECTION 6:
STUDENT DECLARATION
1. I confirm that I have read and understood the School policy on fieldwork and agree to abide
by its terms and conditions;
2. I confirm that the above is an accurate record of my proposed fieldwork and that I have
discussed this with my supervisory team in full;
3. I confirm that I have completed an appropriate risk assessment for my proposed fieldwork
and will submit it with this form;
4. I have attached a full itinerary, timetable of work and approval letter from my sponsor (if
applicable);
5. I confirm that I will contact the School should any of these details change and upon my return
to the University.
SIGNATURES (if by email please tick box)
Date
Student
2 of 3
SECTION 7:
SUPERVISOR SUPPORT
A supporting statement below must be provided by the supervisory team explaining how the
fieldwork meets the conditions laid out in schedule 6.2 (a-d) of the School PGR Handbook.
We/I confirm that the proposed fieldwork has been carefully planned and that it is in the interests of
the student’s research and training; that the location of the proposed study is suitable; that a suitable
work-plan for the period away from the University has been agreed and that supervisory
arrangements are in place.
SIGNATURES (if by email please tick box)
Date
Main Supervisor
Co Supervisor
TO BE COMPLETED ON BEHALF OF THE PGR COMMITTEE
APPROVE
APPROVE IN PRINCIPLE*
REJECT*
REQUEST INFORMATION*
*Please comment below, including any conditions attached to the approval, reasons for rejection or
the further information required.
SIGNATURE
(please cross box if by email)
DATE
Name
Position
PGR OFFICE ONLY
NOTIFICATION SENT
DATE:
CAMPUS SOLUTIONS UPDATED
DATE:
BY:
BY:
3 of 3
Download