UNIVERSITY OF GLASGOW College of Medical, Veterinary and Life Sciences Graduate School Application to Pursue Research Furth of Glasgow Note: for fieldwork you must also attach a completed risk assessment form Please complete all sections Name & student number Academic group or MRes course Purpose and location of research furth (it must be justifiable as essential to your research degree or MRes placement work). Proposed dates of period away Full contact address Arrangements for contact with UoG supervisor (e.g. regular emails, visits, mobile phones, etc): Baseline Emergency Arrangements for local supervision/support Local facilities available to student Has a full risk assessment been completed? (If the work is not being done in a university, research institute or company with safety systems comparable to UoG, you should attach a Risk Assessment form.) (Note any special tasks related to lone fieldwork must be specifically detailed.) Have any local safety regulations been taken into account? Has appropriate fieldwork training (including relevant first aid and emergency procedures) been identified and completed? Has appropriate insurance been arranged? (through the Finance Office) Name (Print) Student Supervisor Institute or School Convenor Signature YES/NO YES/NO YES/NO YES/NO Date