Application for CPD Module, IGCCC Please fill out all sections of the application form and submit, along with the required additional documents, to Libby Hawksley, Secretary IGCCC, at lmf8@st-andrews.ac.uk. The closing dates for submitting application for a CPD module are three weeks prior to the scheduled starting date. Module Selection Which Module are you Please select/delete as appropriate applying for? (NB: you can use the same form to apply for more than one module, if you apply simultaneously) Paris, October 2015 Europe as Hub for Global Cinema: Institutions, Policies, Venues Toronto, November 2015 North America: Cultural Industries, Parallel Circulation, Festivals Paris, January 2016 Arthouse and Festival Programming Hong Kong, March 2016 Asia: Film Culture, Changing Dynamics in Local and Global Circulation St Andrews, June 2016 Theories of Creative Cultures and Global Cinema St Andrews, 2016 August Management, Creative Cultures, and the Festival Galaxy Paris, October 2016 Europe as Hub for Global Cinema: Institutions, Policies, Venues Toronto, November 2016 North America: Cultural Industries, Parallel Circulation, Festivals Personal Details Title Ms/Mr/Other Forename/Given name 1 Initials Forename/Given name 2 Surname/Family name Forename used Date of Birth Permanent Home Address Home Address line 1 Line 2 Town/City County/State/Region Country Postcode (UK only) Home Telephone Mobile Personal email address Correspondence Address Address line 1 Line 2 Town/City County/State/Region Country Postcode (UK only) Preferred Telephone email address All correspondence relevant to your application will be sent to the correspondence address you supply, including any offer letters and instructions throughout the entire admissions process. A correspondence address (if different from your home address) might be an overseas agent or a temporary summer address. Please notify us if your correspondence address changes; if you fail to do so you might not receive vital documents from the University. Further Personal Details Gender Former surname (if applicable) Nationality/Citizenship (required) Dual nationality (if different from above) Country of birth (required) Country of residence/domicile (required) Ethnic origin (required) How did you hear about this course (required) Do you have any criminal convictions or serious criminal charges awaiting trial? Employing organization (if applicable) Sponsoring organization (if applicable) Academic Qualifications 1st Qualification (required) eg. 1st degree Degree/Subject (required) eg. BA (Hons) Business Admin – Applied Economics Academic Year of Award (required) Start Date (required) End Date (required) Final or current avg. score (GPA) University/College (required) Awarding country Examined in English (Y/N) 2nd Qualification – if applicable (required) eg. 1st degree Degree/Subject (required) eg. BA (Hons) Business Admin – Applied Economics Academic Year of Award (required) Start Date (required) End Date (required) Final or current avg. score (GPA) University/College (required) Awarding country Examined in English (Y/N) NB: If you feel any further qualifications or relevant professional experience must be taken into consideration, please detail them on a separate sheet of paper and include with your application. Further Documents Please include all documents in support of your application eg. English Language Test (if applicable). If you believe there is no need to certify your proficiency in the English language, please include a statement to this effect. Curriculum Vitae/Resume – no longer than 2 pages Statement of Purpose – 1 page. Why do you want to take this CPD module? One letter of reference (this could be attached or sent directly to us by the referee). Please include below the name and email address of your referee and be sure to notify him/her that you’ve done so. English Language Qualifications You are required to provide evidence of your proficiency in English depending on your nationality. For CPD purposes we expect a IELTS overall score of at least 6.5. Non-EU applicants who wish for further clarification should refer to the UK visas and immigration website. Please note that if you have graduated from an institution teaching in the English language, you may not need to supply IELTS scores (please make a statement to this effect). We will also take into consideration instances where you work in English-speaking context. English language qualification (eg IELTS, TOEFL none/awaiting result, OTHER) INTERNET, Please provide details of your IELTS. Test report number (required) Test Date (required) Listening Score/Grade (required) Reading Score/Grade (required) Writing Score/Grade (required) Speaking Score/Grade (required) Overall Score/Grade (required) Statement of Purpose Please attach one page long statement, telling us some more about yourself, why do you like to take this CPD module and what do you expect to gain out of it. Reference Please give the names and e-mail address of one referee (academic or work related) It is your responsibility to ensure that the reference reaches you within two weeks of you making this application. You can either supply the letter of reference yourself, or indicate to the referee to send it directly to us. Referee 1 Name & Title Institution & Country Business email Disabilities & special needs Support may be available for students with disabilities and/or special needs including dyslexia. Please provide details below including details of any support required as a consequence of any disabilities or medical condition. Further advice on disabilities is available for prospective students online. Disability Details of special needs and support