WMG Professional Programmes Application Form
Please ensure that you have confirmed your eligibility with the Programme Manager before
submitting your application.
If you are a current student at the University of Warwick or elsewhere, please contact
our Programmes Administrator, Ragvinder Surana, on +44 (0) 2476 523 976 before
completing this form.
SECTION 1
Personal Details
Title
Surname
Forename(s)
Date of Birth(dd/mm/yyyy)
Nationality
Current Home Address
(including postcode)
Home Telephone Number
Email Address
Next of Kin
Relation to Applicant
Next of Kin Telephone Number
Application
What course are you applying for? (please tick)
Master’s Level:
Postgraduate Award (PgA)
Postgraduate Certificate (PgC)
MSc in Cyber Security and Management
MSc in Engineering Business Management (EBM)
MSc in International Trade, Strategy & Operations
MSc in Manufacturing Systems Engineering (MSE)
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MSc in Programme and Project Management (PPM)
MSc in Service Management and Design (SMD)
MSc in Supply Chain and Logistics Management (SCLM)
MSc in Healthcare Operational Management (HOM)
University Of Warwick | WMG Professional Programmes Application Form
If you are applying for a PgA / PgC or Short Course, please indicate below which stream / module
you are applying for:
Academic Year of Entry (e.g. 2012/2013)
Academic History
Please give details of your highest relevant qualification
Name of University/College and country
Date attended (eg 1995-1998)
Degree awarded and class (eg BA Hons 2.1)
Date awarded
Principle subjects taken
Academic Interest and Purpose of Study
Please use this space to briefly describe your special academic interests and your purpose and
objectives in undertaking study with WMG.
Employment History
Please detail your current or most recent employment in the following boxes.
Date from / to
Name and address of current or most recent
employer
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Your work email address
Current position held and nature of work
University Of Warwick | WMG Professional Programmes Application Form
Please enter in the box below details of earlier relevant employment history, including date
from/to, name and address of employer, position held and nature of work. Alternatively, you can
attach an up-to-date CV with this form.
SECTION 2
Your Current Employer
Company Name
Company Address
(including postcode)
Your current position in the company
Your direct line phone number
Your company reception phone number
Your Line Manager Details
Name
Job title/role (in full)
Business unit/department (in full)
Business address
(in full – if different from above)
Telephone
Fax
Your Training Manager Details
(Manager to contact concerning programme progress and/or manager to contact in case of
unexpected non-arrival on a booked/confirmed module)
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Name
Job title/role (in full)
Business unit/department (in full)
University Of Warwick | WMG Professional Programmes Application Form
Business address
(in full – if different from above)
Telephone
Fax
Finance
How would you finance yourself at Warwick
Self
Self and employer
Fully sponsored by employer
Fees and Billing
Please note that to complete participant registration with the University of Warwick, appropriate
purchase order cover for a minimum of one year’s fees must be provided. This applies to all
participants irrespective of the frequency of invoicing selected.
Name of person to whom invoices should be
addressed
Job title/role (in full)
Business unit/department (in full)
Business address
(in full - if different from above)
Telephone number (including area code and, if
applicable, extension)
Fax number (including code)
Purchase Order
Purchase Order Number
Purchase Order Value
Please indicate which year(s) of the
programme this P.O. covers
Year 1
Year 2
Year 3
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Please indicate how your company wishes to
be invoiced
Annually
Quarterly
University Of Warwick | WMG Professional Programmes Application Form
Billing for Non-fee Inclusive
Details (if different from above) to whom invoices should be addressed for non-fee inclusive
services e.g. extra night’s accommodation. Please note that incidental expenses e.g. newspapers,
bar bills, personal photocopying etc. should be paid for when checking-out from Arden House after
each module.
Name of person to whom invoices should be
addressed
Job title/role (in full)
Business unit/department (in full)
Business address
(in full - if different from above)
Telephone number (including area code and, if
applicable, extension)
Fax number (including code)
Fee Guidelines
Please sign to confirm that you are aware of
WMG cancellation policy and will honour any
cancellation charges incurred.
Please sign to confirm that you are aware of
WMG fee structures with particular reference
to the implications of selecting quarterly or
annual billing.
SECTION 3
References
Individuals must provide at least two professional references from within their current company.
These are normally written by the Human Resources department and by the individual’s line
manager. These references should indicate how the candidate is suitable for the chosen
programme.
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Referee 1
Referee 2
Name
Name
Position
Position
Address
Address
Telephone
Telephone
Fax
Fax
Email
Email
University Of Warwick | WMG Professional Programmes Application Form
You can either attach your reference letters to this form and send by post, or scan your original
letters and send them by email. If you choose to send us your letters in an electronic format, you
will need to provide us with the original letters, printed on headed paper and signed by your
referees, before you are able to start the course.
Please tell us what made you apply to us:
□ Colleague recommendation
□ Company recommendation
□ Personal recommendation
□ WMG Reputation
□ Search engine
□ Course format/flexibility
□ Course content
□ Other
………………………………………………………………..
Declaration
I hereby apply for admission to postgraduate studies at the University of Warwick and I confirm that
the information provided above is correct to the best of my knowledge. I understand that any offer of
admission may be withdrawn if I cannot provide documentary evidence of any statements on this
form.
Signature
Date
Terms and Conditions
Cancellation charges will be applied in accordance with our standard conditions as
described below.
Cancellation charges are levied on late cancellations or non-attendance. WMG's standard cancellation
policy will be applied as follows:
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1.1
Written notice of cancellation received by WMG more than four weeks (20 full working days) prior
to the first day of the module; no charge.
1.2 Written notice received by WMG between four weeks (20 full working days) and two weeks (10 full
working days) prior to the first day of the module; 10% of the module fee.
University Of Warwick | WMG Professional Programmes Application Form
1.3 Written notice received by WMG less than two weeks (10 full working days) prior to the first day of
the module; 50% of the module fee.
1.4 No written notice received and participant does not attend the module; 100% of the module fee.
WMG will not apply the above late cancellation charges in the following circumstances:
a.
b.
c.
d.
Certified illness
Authorised paternity or maternity leave
Bereavement
Exceptional circumstances, approved by the WMG Director of Programmes
.
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University Of Warwick | WMG Professional Programmes Application Form