OCMS St. Philip & St. James Church, Woodstock Road, Oxford, OX2 6HR, United Kingdom ocms@ocms.ac.uk +44 1865 556071 ◦ www.ocms.ac.uk Application for Research Associate Status Thank you for seeking admission to OCMS as a Research Associate. We would be grateful if you would complete the enclosed form so that the Admissions Committee may assess your suitability for such a position. Please send a covering ‘letter of application’ outlining why you would like to come to OCMS and what you would hope to do whilst here. We look forward to receiving your application. If there is anything more that you would like to know about OCMS or the Research Associate programme please refer to the OCMS website at www.ocms.ac.uk, or contact the Admissions Tutor. Completed applications may be sent to: Admissions Office Telephone: +44 (0) 1865 556 071 OCMS, St Philip and St James Church Woodstock Road, Oxford, OX2 6HR Fax: +44 (0) 1865 517 722 E-Mail: rmcintyre@ocms.ac.uk United Kingdom Website: http://www.ocms.ac.uk/content/ PERSONAL DETAILS Surname (Last /Family Name): First Name: Title: Other forenames: Date of Birth (dd/mm/yy): Gender: Marital Status: Nationality (Country): Ethnic Origin if different from nationality: Address for Correspondence: Permanent Residential Address: Country: Postcode: Telephone Number: Country: Postcode: Skype: E-Mail Address: CURRENT EMPLOYMENT Company/Organisation Name: Address of Employer: Category of work Country Terms (ft/pt/self employed): Job Title: Date of Commencement: Key Responsibilities: PREVIOUS EMPLOYMENT Please list your most significant employment history. Organisation Country Job Title Dates Responsibilities 2 ACADEMIC BACKGROUND Please list the academic and professional qualifications you have been awarded since leaving secondary school. Dates University/ Institution/ Qualification Subject College Result/Level Date Awarded LINGUISTIC PROFICIENCY If your first language is not English, please give an indication of your competence in spoken and written English and, where appropriate any Certificates indicating your competence in English Is English your first language? Yes/No Is English your working language? Yes/No If the answer to both of the above questions is ‘No’ please provide your International English Language Testing System Level (IELTS) Test Overall Grade/Score ILTS Level Lowest individual score Date Place 3 REFERENCES Please provide details of two people who could advise us on your suitability to benefit from a Research Associate position; one a personal reference and one who could comment on your academic ability Person 1 Academic or Professional How do you know referee? Name Title/position Postal address Country E-mail address Phone number Person 2 Academic or Professional How do you know referee? Name Title/position Postal address Country E-mail address Phone number Person 3 Academic or Professional How do you know referee? Name Title/position Postal address Country E-mail address Phone number 4 FINANCIAL INFORMATION Please note below how you intend to meet the financial commitments of becoming a Research Associate. Will your fees be paid from your own finances, be paid by your employer or from friends and church? Year per week per day 2015 – 2016 £195 £48 2016 – 2017 £200 £52 2017 – 2018 £205 £55 (please note that this information will be treated IN CONFIDENCE (Please do not leave this blank) Source of Funding Your Employer: Amount Raised Percentage of Total Personal Sources and Contacts: Scholarships / Bursaries: applied for / granted Funding Agency: Amount still to be raised 5 YOUR PROPOSED RESEARCH INTEREST AREA Please give below an outline of what you would propose to work on in your period as a Research Associate at OCMS. Please state the area, the research question, and why you would want to work on it. Note also any work that you may already have done on this topic. (Note: whilst this proposal will not be binding on you it will give us an indication of your thinking at this stage.) What is it that you wish to research? Why is this research important to you, or to others? – Tell us how your topic is connected to literature and other research you have done. How do you expect this research to make a contribution to the wider body of knowledge in your discipline. What motivates you to do this research? – If your research is practitioner based explain how that is relevant to your study. Have you done any previous research / study / reading / writing in this area? If so give a brief description of your progress please include a bibliography of at least 25 sources relevant to your topic. 6 GENERAL ARRANGEMENTS As each application for Research Associate status at OCMS is individual to that individual, we would want to discuss with you personal arrangements that would be mutually convenient. To this end, it would be helpful if we had the following information as ‘starters’. If currently employed, have you discussed with your employer this application? If employed, does your employer support this application? How long would you wish to spend working as a research associate? When would you hope to be able to start working in Oxford? Would you wish to work part time or full time? If part-time, how many days per week? Would you wish to stay in Oxford or commute daily or weekly? Would your time as a Research Associate be best considered as a Sabbatical, Study leave, Leave without pay, Post employment or Job change break? Feel free to amplify your response. Please feel free to add any further comments here which would be helpful to us in considering whether a period working as a Research Associate at OCMS would be of mutual benefit, in God’s service. Please indicate how best we could discuss this application with you, by phone, skype, email, or face to face discussion. If a meeting, phone call, or skype communication can be arranged, please indicate which dates would or would not be suitable for you, and when you will and will not be in the country. HEALTH/HEALTH INSURANCE How would you describe your general state of health? Have you suffered any serious illness or undergone medical treatment in the last five years? If yes, please explain: Are you currently on any prescribed medication? If yes, please explain: 7 Please specify any physical or learning difficulty which might necessitate special arrangements or facilities Physical disability Learning disability. If you are not eligible for free health care benefits in the UK (if unsure, please refer to note and website below), you are required to submit documentation of private health insurance coverage with your application. Note: Access to free health care in the UK is restricted to people who qualify under UK law. If you, or any dependents who accompany you, are not entitled to free health care in the UK each person must take out private health insurance for the duration of their travel and time in the UK. Please refer to http://www.dh.gov.uk/en/Healthcare/Entitlementsandcharges/OverseasVisitors/index.htm DECLARATION I confirm that the information provided in this application is true, accurate and complete, and I consent to the OCMS contacting the referees supplied. (Please tick the box) □ Data Declaration: I agree that OCMS may store and process by computer or otherwise, all personal information supplied with this form for the purpose of enrolment at OCMS and registration for a research degree. (Please tick the box) □ If I am submitting my application online, I will post a hand signed form with application fees and other documents after completing the online application. (Please tick the box) □ Name: Signed: Date: 8