Understanding Research Training Programme
Application Form
Please complete this form in BLOCK CAPITALS
Proposed Date of Entry
to the Understanding Research Training Programme
September
20 _ _
Subject Area
Following successful completion of the Understanding Research Training Programme, please indicate
the award you intend to apply for:
Professional Doctorate Programmes
Built
PrD
MProf
PG Dip in Professional Research
Environment
Business
DBA
MProf
PG Dip in Professional Research
Health &
Social Care
PrD
MProf
PG Dip in Professional Research
Education
Ed.D
Laws
LLD
Practical
Theology
PrD
NB Mode of Study is Part Time only for Professional Doctorate Programmes
Personal Details
Title
Male/Female
Surname/Family Name
Previous Surname
First Name(s)
Date of Birth (dd-mm-yy)
Permanent home address
Contact Address (if different from home address)
Postcode
Postcode
Telephone no.
Telephone no.
Email address
Email address
Fees Information
Who is expected to pay your fees?
Yourself
Sponsor
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Further Details
Country of domicile
Country of Birth
Nationality
Have you been permanently resident in the UK/EU for the last 3 years for other than educational
purposes? Yes
No
Please give date of entry
Do you have any unspent criminal convictions in any country?
Yes
No
Learning Support Needs
Do you have any learning support needs or mobility requirements?
Yes
No
(If your answer is ‘yes’ a member of our Student Support Services will be in
contact with you about your requirements)
FOR OFFICE USE ONLY
Data entry date
SID
Education, Qualifications and Training
Higher Education/Further Education/Secondary Education (please list most recent first)
Name of Institution
From
(mm/yy)
To
(mm/yy)
Full time?
Continue on separate sheet if necessary
Qualifications Completed or Relevant Training Undertaken (please list most recent first)
Qualification
Subject
Grade
Date Awarded
Continue on separate sheet if necessary
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Qualifications Pending or Continuing training
Qualification
Subject
Expected Date (mm/yy)
Grade
Continue on separate sheet if necessary
Evidence of English Language level
For English Language level required please visit:
http://www.anglia.ac.uk/ruskin/en/home/central/rds/services/research_office/research_degrees/prospective_students.html
If English is not your first language, please complete one of the two options below:
Name of last examination taken (eg IELTS or TOEFL)……....................................Result…………………
Original/ Copy of certificate enclosed?
Yes
No
If ‘No’ please explain……..…………………………………………………………………………………………
…………………………………………………………………………………………………………………………
OR Evidence of study through the medium of English enclosed?
Yes
No
Professional Body Membership
Professional Body
Date Joined
Continue on separate sheet if necessary
Employment
Current Employer
Name of Organisation
Address
Department
Job Title
Date appointed
Continue on separate sheet if necessary
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Supporting Information
Area of Research Interest
Please indicate in general terms the area of your research interest. (300 words maximum)
If you have discussed your application with a particular academic member of staff, please state
that person’s name here
Name
Telephone no.
Email address
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Referees
Please provide details of one academic and one professional referee
Name
Name
Address
Address
Postcode
Postcode
Telephone no.
Telephone no.
Email address
Email address
Post/Occupation
Post/Occupation
Data Protection Act 1998
I agree to the University processing personal data contained in this form or other data which the University may
obtain from me or other people. I agree to the processing of such data for any purposes connected with my studies
or my health and safety whilst on the premises for any legitimate reason including communication with me following
the completion of my studies.
In addition, I agree to the University processing personal data described as Sensitive Data within the meaning of
the Data Protection Act 1998, such processing to be undertaken for any purposes as indicated in the declaration
above.
Declaration
I certify that to the best of my belief this information I have provided is complete and true
Signature of applicant
Date
Certification of Qualifications
Please note that all applicants must include copies of the following when returning this application form:
 Academic Certificates (officially translated and certified if not UK)
 Academic Transcripts, including subjects studied and grades achieved (officially translated and
certified if not UK)
 Evidence of English Language level (if English is not your first language)
Please note, a confirmed offer will only be made when certified copies of documentation
have been received by the Admissions Office
Please return this form to the Admissions Office:
E-mail: Admissions@anglia.ac.uk
Or Address: Admissions Office, Anglia Ruskin University, Bishop Hall Lane, Chelmsford,
CM1 1SQ
Or Fax no: +44 (0)1245 607520
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