Ref: RDSA FORM (July 2009)
FOR OFFICE USE ONLY
Student Number:
Received by:
Fee Category:
Date:
Home
Overseas
Director of Studies:
Studentship Reference Number:
Please return to:
(located before project title on web site)
2015 / _ _
Research Degree Studentship Application Form
Please complete the form below and forward your application to the address above who will then contact you directly.
Submission of this form does not in any way obligate you or the University.
Please note that you are not accepted onto a research degree programme at this University until a full Research Proposal has
been approved and signed by the Faculty at which point you will be required to enrol and will be liable for payment of fees.
1. PERSONAL DETAILS
Title (Mr / Mrs / Miss / Ms etc)
Family Name on 16th Birthday
Family Name
First / Given Name(s)
Main Contact Address
Home Address (if different)
Postcode
Postcode
Main Contact Telephone Number
Mobile Phone Number
Home Telephone Number (if different)
Fax Number
E-mail Address
SEX:
Male (M)
Date of Birth (e.g. 15/03/1972)
Day
Month
Year
Female (F)
DISABILITY/SPECIAL NEEDS
If you have a disability / special need and may require extra support in your study or accommodation, please
enter in the box the type of disability code (See Notes for Guidance)
Please give details of the disability(ies) and indicate clearly what help you may require:
Are you in receipt of Disabled Students’ Allowances? Yes/ No
CRIMINAL CONVICTIONS:
If you have a relevant criminal conviction, enter X in the box
See Notes for Guidance for a definition of relevant convictions.
2. FURTHER DETAILS
Nationality:
Area of Permanent Residence:
Country of Birth:
If country of birth is not UK, when did you first come
to live in the UK?
Have you lived outside the UK during the past three
years? (YES/NO)
Residential Category (please see notes
for guidance):
If YES Please
give details:
Who will be paying your tuition fees? (please give
full name and address) (If you are a member of staff at
the University, a Pathways agreement must be attached)
3. PLANNING STATISTICS (For statistical purposes only)
Please choose from the ethnic origin terms printed in the Notes for Guidance which you feel most clearly
describes your ethnic origin and write its code in the boxes.
National Identity Code
4. QUALIFICATIONS GAINED: (Degree level and above only)
Name of Qualification
(including Awarding Body)
Duration/
Date
(mm/yy –
mm/yy)
Subject(s)
Result
Level/
Credit
Rating
Mode of
Study
(Full or
part
time)
Place of Study
(College/University)
5. ENGLISH LANGUAGE QUALIFICATION (International Students):
Please complete if you are an international student and append evidence of score (minimum required – IELTS score of 7.0
TOEFL Score
IELTS Score
Other Score (Please specify)
6. ACADEMIC REFERENCES:
Please give the names, qualifications, positions and addresses of two academic references to whom an approach may be made
by the appropriate Research Institute or Approved Unit
Name of Referee 1
Name of Referee 2
Position
Position
Address
Address
Telephone Number
Telephone Number
Fax Number
Fax Number
E-mail Address
E-mail Address
7. PREVIOUS RESEARCH EXPERIENCE:
Please give details of previous research experience (if any); including any project undertaken as part of a first degree course
and/or other relevant work experience.
8. DECLARATION
I confirm that the information given on this form is true, complete and accurate and no information requested or other material information
has been omitted. I understand that the information provided will be held and processed by the University in accordance with the Data
Protection Act (the Act) and I give my express consent to the processing of my personal sensitive data as defined by the Act by the University.
I have read the Notes for Guidance and I undertake to be bound by them. I undertake to pay or cause to be paid to the University of
Wolverhampton by the due date, all fees and charges for tuition, accommodation and other services and goods supplied to me by the
University, should my application be successful.
Insert name to show acceptance of Declaration
Date
Guidelines for the Completion of the Studentship Application Form
PERSONAL DETAILS
This section asks for details about your self and your qualification. Please note that all subsequent changes to your
name and / or address MUST be communicated without delay both to Student, Transnational and Research
(STaR) Office. Full personal details and details of your higher education qualifications (and, in the case of
International Students, your English Language qualifications) should be given in the appropriate sections on the
forms, including the main subjects studied hitherto, so that a reasonable assessment of your academic suitability
can be made.
We should also like to know whether you have previously studied at the University of Wolverhampton and if so
document your student number, if not, how you heard of our Postgraduate Research Programmes.
DO YOU HAVE ANY CRIMINAL CONVICTIONS?
The University asks you to say on your application whether you have any criminal convictions. This is to help us
ensure a safe environment for all our students.
If you have been convicted of a criminal offence you are required to tick the Yes box in section A1 of your form.
‘Criminal offences’ here exclude (a) a motoring offence for which a fine and/or maximum of three penalty points
were imposed or (b) a spent sentence (as defined by the Rehabilitation of Offenders Act 1974), except for certain
courses – see below. If you have not been convicted of a criminal offence you must complete the No box. If you
do not tick either box, we will need to contact you to obtain this information and this will delay your application.
You should be aware that for certain courses particularly related to Teaching, Health and Social Work programmes
or courses involving work with children, any criminal conviction, including spent sentences and cautions, must be
declared. If you are in any doubt, you should contact the University and seek advice.
If you are not sure whether to tell us about a previous conviction, you should get more advice from a UK Citizens
Advice Bureau or probation service, or from NACRO (the National Association for the Care and Resettlement of
Offenders). You can also contact a solicitor, but you may have to pay for legal advice.
If your circumstances change after you have applied (for example you are then convicted of a criminal offence)
you must declare this information to the University.
Serving Prisoners
If you are currently serving a prison sentence you must show the prison address for correspondence in section 1 of
your application form, and in addition you must complete the Yes box in this section.
DISABILITY/SPECIAL NEEDS
The University is very willing to help students with disabilities. In order to allow us to provide the best available
support for you, we need to know about the nature of your disability and how it might affect your studies. The
information you provide will not affect judgements concerning your academic suitability, and will be treated
confidentially by the University.
If you have a disability and may require extra support in your study or accommodation, please enter on the form
the code that is most appropriate to you from the list below. If more than one disability applies to you, please use
code 8.
1.
2.
3.
4.
5.
6.
7.
8.
9.
0.
You have dyslexia
You are blind/partially sighted
You are deaf/hard of hearing
You are a wheelchair user/have mobility difficulties
You need personal care support
You have mental health difficulties
You have an unseen disability, e.g. diabetes, epilepsy, asthma, heart condition
You have two or more of the above disabilities/special needs
You have a disability not listed above
You do not have a disability or are not aware of any additional support requirements in study or
accommodation.
SECTION 2: TO BE COMPLETED BY THE CANDIDATE
NATIONALITY AND RESIDENTIAL CATEGORY
You are required to identify your residential category for statistical purposes and to determine funding implications.
Enter on the form one code from the table below which best describes your residential category:
A
You or your parents are British citizens or nationals of another European Union country and
a) you have lived in the European Economic Area for the past three years, apart from
temporary absences, and will continue to do so; and
b) your residence has always been for a purpose other than full-time education.
B
You do not fulfil the conditions of category A above, but
i) you have lived in the UK for the past three years, apart from temporary absences, and will
continue to do so; and
ii) your residence has always been for a purpose other than full-time education; and
iii) the length of your stay in the UK will not be limited by UK immigration control on 1st
September of the year of commencement of your programme of studies.
C
You, one of your parents or your spouse are recognised by the UK Government as a refugee or have
been granted Exceptional Leave to Enter or Remain as a result of an asylum application and have
lived in the UK since that status was granted and will continue to do so until 1st September of the
year of commencement of your programme of studies, apart from temporary absences.
D
You are a national of Iceland, Liechtenstein or Norway, resident and employed in the UK as a
migrant worker, or child or spouse thereof, ordinarily resident in the EEA and not for purpose of fulltime education.
G
You are a UK/EU national, or child of, temporarily employed outside the EEA, otherwise ordinarily
resident in the EEA.
O
Other
Please note this self-coding is provisional. The University may require additional information.
SECTION 3: TO BE COMPLETED BY THE CANDIDATE
PLANNING STATISTICS
This information is used purely for statistical purposes. State on the form the code from the following table which
best describes your ethnic origin.
Ethnic Origin Codes
White
British
Irish
Other white background
11
12
19
Black or Black British
Caribbean
African
Other black background
21
22
29
Other ethnic background
80
Asian or Asian British
Indian
Pakistani
Bangladeshi
Chinese
Other Asian background
31
32
33
34
39
Mixed
White and Black Caribbean
White and Black African
White and Asian
Other mixed background
41
42
43
49
SECTION 4&5: TO BE COMPLETED BY THE CANDIDATE
QUALIFICATIONS GAINED (INCLUDING ENGLISH LANGUAGE QUALIFICATION)
You need only enter here the highest level qualification gained, including details of the award, subject, date and
awarding body. The minimum entry requirement for registration for the degree of PhD is normally a first or upper
second class honours degree from a UK University, or a qualification which is officially regarded as equivalent to
such an honours degree; any exception to this rule must be formally justified.
Should you require an English Language qualification, please note that the minimum requirement for entry onto
the PhD is an IELTS score 7.0 or a pass in the Cambridge Certificate of Proficiency in English (CPE) examination. If
you have obtained a Masters level qualification from a UK University, this is usually considered to be acceptable;
however, each case is considered on its merits.
SECTION 6: TO BE COMPLETED BY THE CANDIDATE
ACADEMIC REFERENCES
The Faculty to which you will be attached may well wish to take up academic references. The persons named
should be different from those proposed in the supervision team; at least one referee should be independent of
both the University and of any collaborating establishment.