MSc/Diploma/Certificate in Medical Mycology by web based distance learning Supplementary Application Form Please attach this form as a ‘supporting document’ to your main application form at http://www.ucl.ac.uk/prospective-students/graduate-study/application/taught Preparing your application Embarking on a postgraduate degree is a major step in your professional career and your personal life. This supplementary application form is designed to help you decide whether our Programme will meet your personal objectives and fit in with your other commitments. Please study carefully the details of the course given in the information pack and reflect on the questions we ask in this form. Please also talk with your family, your friends and your colleagues about this Programme. If you satisfy our admissions criteria and are confident that our MSc/Diploma/Certificate is the best one for you, we look forward to receiving your completed application. Dr Chris Kibbler Programme Director Our admissions policy Our objective is to admit a multidisciplinary group of motivated and experienced professionals who will work together by distance learning in a virtual environment, and through a series of practical classes, to share ideas, experiences and perspectives in the field of medical mycology. To be considered for a place you must demonstrate all of the following through your application form, your personal statement, and your references: Intellectual capacity You must have a quality undergraduate degree or equivalent in Microbiology or another biomedical science (including Medicine). Professional experience In the event that the course is oversubscribed, your application will be judged on the quality and appropriateness of your previous academic and professional experience, references, and your personal statement. Team skills You will be working with a range of professionals of different cultural and professional backgrounds. We look for evidence that you can work productively in a multidisciplinary group, showing respect, support and willingness to learn from your fellow students regardless of age, gender, ethnicity, professional status or political persuasion. Personal motivation and maturity This MSc/Diploma/Certificate is a demanding experience. It requires a substantial time input (between 10 and 15 hours per week for 3-5 years) and will sometimes need to take priority over your other commitments. We look for evidence that applicants are reflective, mature and realistic, as well as ambitious and highly motivated. Computer literacy Essential prerequisites include familiarity with a range of Windows based software packages such as Word, Excel, and Powerpoint, the ability to read on screen, to type quickly and accurately, to present formal written work in an ordered and structured manner, and to use an approved and consistent style of referencing. You should also possess basic search skills for electronic databases. Language ability The MSc/Diploma/Certificate Programme is taught and examined in English. To participate fully in virtual seminars, you need to be able to read and write fluently in English. If English is not your native language you must provide evidence of a competent standard of written English. Details of UCL’s requirements in this area are given in the following web page http://www.ucl.ac.uk/prospective-students/graduatestudy/application-admission/english-language. Support from a local mentor Most of your studies for this MSc/Diploma/Certificate will be undertaken at a distance from University College London. We require all participants to be supported by a local mentor. Details of our requirements for mentors are given in Section Six of this application form. 291220948 Section One: Your employer details for our departmental records 1. Job title/department 2. 3. Work address Work telephone (with extension) Fax number 4. 5. What was your main source of information about this MSc/Diploma? Journal ad (BMS) Journal ad (other) Word of mouth Internet (UCL) Internet (BSMM) Internet (other) Lecture/presentation Flier Prospectus Other (please explain) 6. What have you gained from your current/previous work experience that you could contribute to a multidisciplinary study group of other health professionals? Section Two: Your computer and how you use it Please tell us about the main computer you intend to use for your MSc/Diploma/Certificate studies 7. Make and model 8. Memory (disk and RAM) Operating system (e.g. Windows NT, Mac OS) 9. Do you have access to a dedicated phone line for Internet use? 10. Please indicate your experience and ability in the following aspects of computer work Using Word to type a document Inserting references (e.g. Endnote or Reference Manager) Using Powerpoint to produce presentations or figures Using excel to enter numerical data and do calculations Sending, receiving and storing email messages Joining in an interactive email discussion via list server Using the Internet to find information Indexing Internet sites (e.g. via 'bookmarks' or 'favourites') Searching the Medline database Searching other databases (e.g. Cochrane) 9. Totally unfamiliar Could do with help Could do unaided Could teach this to others 2 Section Three: Fitting this course in with your work and personal life 11. Web based courses offer the opportunity for flexible study, but students sometimes wrongly assume that the time commitment will be less than a taught course. Please state below how you plan to fit this MSc/Diploma/Certificate in with your work and personal commitments. Note that in order to study effectively at postgraduate level, you will almost certainly have to give up some other regular activity. Your answer may be as short as 100 words and must not be longer than 300 words. Section Four: Your local mentor This person should provide personal support as you try to combine your studies with your work and other commitments. The local mentor is not expected to provide academic input to the Programme. If you already know who your mentor would be, and if they agree to taking on this role, please give their details below. Otherwise, please complete the last question in this section. Please read the ‘Guidelines to Supervision of Students’ document enclosed within the application pack. 12. Mentor's name 13. Mentor's address 14. Mentor's phone (with area code) 15. Mentor's fax (with area code) 16. Mentor's email address 17. I have not yet identified a local mentor but I plan to appoint one before commencing the MSc/Diploma/Certificate Section Five: Your declaration and commitment I hereby apply for a place on the MSc/Diploma/Certificate in Medical Mycology commencing October ______ (year). I understand that the decision to offer me a place rests with the Programme Director and the Registrar of University College London, whose decision is final. If I am offered, and accept, a place on the MSc/Diploma/Certificate in Medical Mycology, I undertake to abide by the rules and regulations of University College London and the University of London. I confirm that to the best of my knowledge the information contained in the application is accurate. 18. Your name 19. Your signature to agree to the above Thank you for completing this supplementary application form, which will help us decide if you have the necessary background and skills to join the MSc/Diploma/Certificate in Medical Mycology. Please attach this as a ‘supporting document’ to your main application form at http://www.ucl.ac.uk/prospective-students/graduatestudy/application/taught 3