Vet Learning Ltd
Professional Development Foundation
Middlesex University
Application Form
To be used for all PDF programmes, including DProf
(Not to be used for other University applications)
Please read enclosed Notes for Guidance before completing the form
STUDENT NUMBER:
(If you have previously studied at
Middlesex University please enter your
student registration number)
1. Surname/Family Name (BLOCK CAPITALS)
2. Nationality
Title: Mr/Mrs/Miss/Ms/Other- Please state
Country of Birth
First Name(s)
Country of permanent residence
Previous Surname (if changed)
Gender:
Date of Birth
Applicants not born in the European Community please state:
Date of first entry to the EC
Male

Female

Address (for correspondence)
Date of most recent entry to the EC
Date from which you have been granted permanent residence in
the EC
UK Postcode
RCVS Number:
Permanent address (if different from above)
Are you already enrolled with RCVS
(CertAVP Candidates only)
Yes

No

Payment of fees: Who will pay your fees?
Telephone (including country code)
(Day-time)
 Self
(Evening)
Employer/Sponsor (please give full invoice details see
Section 2 of Notes for Guidance)

(Mobile)
Fax
 Other (Please specify)
E-mail
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3. Programme/Modules applied for:
(For example: Masters/Doctorate in Professional
Development : see Notes for Guidance)
Foundations of Advanced Veterinary Practice
Small Animal Practice
PDF/RCVS
Module
Code
Indicate all
that apply
Proposed
start date
PDF4110
A-FAVP.1
PDF4130
B-SAP.1
Production Animal Practice
B-PAP.2
Equine Practice
Clinical Audit
Consultation Skills
Professional Responsibility and Practice
Clinical Coaching & Mentoring
Principles Of Veterinary Management And
Leadership
MSc(VetGP)
B-EQ.3
PDF4140
C-VGP.1
PDF4150
C-VGP.2
PDF4160
C-VGP.3
PDF4026
Pending
PDF4025
C-VML.1
Structured PhD
Doctorate of Professional Studies
CertAVP Candidates only
Are you enrolling for module credits only or
Middlesex Postgraduate Certificate
Module Credits only
Yes
No
Middlesex Postgraduate Certificate
4. Work experience: (Please consult Notes for Guidance before completing this section).
Give details of your employment. You may attach a CV if you wish.
Job Title
Nature of work experience/ employment
Name of organisation
Full-time
or
Part-time
From
mm/yy
To
mm/yy
2
5. Ethnic origin: please note that this information is required for
equal opportunities monitoring only. Please tick the appropriate
Census category
Asian/Asian British-Indian
Asian/Asian British-Pakistani
British/Bangladeshi
Other Asian Background
Black/Black British-African
Black/Black British-Caribbean
Other Black Background
Chinese or other ethnicity/
Chinese
White/British
7.
6. Disability/special needs: (please insert appropriate
code as shown in Section 4 of Notes for Guidance)
White-Irish
Other White Asian/Asian
Mixed White/Asian
Mixed White/Black-African
Other Mixed background
Other Ethnic background
Not Known
Information refused
Qualifications: Please list all Degree or other qualifications including professional qualifications in chronological
order. If you are awaiting the result of any qualification write pending in the result column.
Qualification
Subject
Month
Year
Place of study
Results
(grades or
bands)
CATS points
(if
applicable)
3
8.
Personal Statement
In approximately 1000 words provide a reflective account of your career to date and the reasons for your interest in
this course
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Personal Statement (continued)
9.
Declaration: I confirm that, to the best of my knowledge, the information given in this form is correct and complete.
I have read the instructions, in particular those relating to this section. I understand what they say, and agree to
abide by the conditions set out there, which I accept as conditions of this application.
Applicant’s Signature
Date
Please return this form to:
Chris Whipp
Vet Learning Ltd
8 Kings Parade
Soham
Cambs CB7 5AR
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Notes for Guidance
General
Before completing the form, PLEASE ENSURE THAT YOU READ THESE NOTES FOR GUIDANCE CAREFULLY. You should also
read the current University literature relating to the programme for which you are applying, in order to ensure that you
are familiar with the curriculum and entry requirements.
The Data Protection Act
This information will be held on computer in accordance with Middlesex University’s registration under the Data
Protection Act and used only for the purpose of education and training, and statistical monitoring.
Please ensure when completing your application form that your writing can be easily read by others.
Electronic completion of this form is acceptable as is the use of electronic signatures
Section 1: Personal details
Complete this section in BLOCK CAPITALS
Previous surname: if you have changed your name by marriage or otherwise, state your previous surname or family
name.
Correspondence address: enter the address to which you expect all correspondence to be sent. It is important that you
inform us of any change of address immediately.
Veterinary surgeons should include their RCVS number
CertAVP students should confirm whether they have already enrolled with RCVS or not
Section 2: Fee status
If you live in the UK state your area of permanent residence. If you live outside the UK, state the country where you are
living as your area of permanent residence.
Please give details of who you expect to pay your fees for the proposed course. Your application cannot be
processed without relevant documentation.
If your employer or sponsor is paying your fees a letter must be enclosed from your employer/sponsor confirming
that your fees will be paid and giving contact details for invoicing.
Do not enter your Local Education Authority as fee payer unless you have written confirmation from them that you are
eligible for a student grant. (eg you must be a full-time student and LEAs rarely give grants for Postgraduate study)
Section 3: Details of the course to which you wish to apply
Confirm the title programme or modules you are applying for (if this is already known
CertAVP candidates should indicate whether they are applying for module credits only of the Middlesex University post
graduate certificate (Speak to a member of Vet Learning staff if unsure).
Please ensure that you include a photocopy of the relevant qualifications for which you already have credit.
Section 4: Work experience and employment
Please include all your work experience paid or unpaid, full-time or part-time in your home or outside. Please also attach
a CV if you can as this is particularly helpful for admission purposes.
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Section 5: Ethnic Origin
Please state your ethnic origin. This information will not be made available for selection purposes and is collected solely
for the purpose of statistical monitoring (e.g. application and admission rates). This is not a compulsory section.
Section 6: Disability/Special Needs
Please enter in the box the code from the list of statements below which is most appropriate to you and where it is not
obvious, ie with unseen disabilities, indicate whether you have special needs.
Disabilities/support required: 0. You do not have a disability nor are you aware of any additional support requirements in
study or accommodation. 1. You have dyslexia. 2. You are blind/are partially sighted.
3. You are deaf/have a hearing impairment. 4. You are a wheelchair user/have mobility difficulties. 5. You need personal
care support 6. You have mental health difficulties. 7. You have an unseen disability, eg diabetes, epilepsy, asthma. 8.
You have two or more of the above disabilities/special needs. 9. You have a disability not listed above.
Section 7: Qualifications
Please list your qualifications. Include any professional qualifications and certified short courses you may have attended.
Section 8: Declaration
Any offer of a place you may receive is made on the understanding that in accepting it you agree to abide by the rules
and regulations of the University, and by signing this form you are confirming your agreement to this.
Section 8: Personal Statement
1. All candidates
Please provide in approximately 1000 words a reflective account of your career to date and your reasons for choosing
the course selected. You must submit a personal statement to be considered for the programme.
2. DProf applicants
Please ensure you clearly indicate why this is an appropriate programme for you and what you are seeking to achieve.
You must submit a personal statement to be considered for the programme.
Note: Please ensure that the following declaration is completed and submitted with the application form.
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IMPORTANT NOTE
The University will use its reasonable endeavours to deliver courses in accordance with the descriptions set out in its
prospectuses and guides. However, the University issues this literature as a general guide to all the courses and facilities
offered by the University at the time of going to print. The prospectuses and guides are not intended, nor should they be
considered, to contain definitive course descriptions and facilities.
The University does not provide education to UK undergraduates on a commercial basis and it is also dependent on
public funding and donations. The University therefore has to manage itself in such a way which is efficient and cost
effective to the majority of its members, having obligations to funding and other outside bodies in this regard. It
therefore reserves the right to make changes to the contents or methods and/or locations of delivery of courses, to
merge or combine courses or to discontinue them, if such action is considered to be reasonably necessary by the
University in the context of its wider purposes.
If the University discontinues any programme of study after an offer of a place has been accepted, it will use all
reasonable endeavours to provide a suitable alternative course at the University or to give all reasonable assistance in
helping to find a suitable alternative course at another institution. If a programme of study is discontinued and a student
cannot be relocated onto another course within the University or otherwise and the student has not unreasonably
refused the offer of a transfer to another course within the university or otherwise, the University may in its discretion
reimburse any tuition fees, wholly or in part, paid by the student to the University up to the date of the discontinuation
of the programme of study. The University will not be liable for any other loss claimed to be suffered by the student as a
result of a course being discontinued. The University, on a discretionary basis and without obligation, may offer further
assistance in exceptional circumstances to a student where the student can show that they have suffered or will have to
suffer severe hardship as a direct result of such discontinuation.
Professional Development Foundation Terms and Conditions for Students Undertaking Study with the
PDF/MDX Professional Development Programme
1.
2.
3.
4.
5.
6.
7.
8.
The PDF undertake to make available the learning support and resources required to allow the student to complete
their studies. Details of the support provided within each module of study are given in the PDF Handbook. It is the
student’s responsibility to ensure they access this support and resource.
The PDF will invoice students for the agreed annual fee at the beginning of their period of study and once a year
thereafter on the anniversary of the student’s registration for their studies. All students are required to pay these
fees within four weeks of the date of invoice. Failure to pay fees can result in the withdrawal of all tutorial support
and disabling of passwords and usernames for electronic learning resources.
All students will have access to electronic learning resources via the virtual learning environment (VLE). Access to
these resources is dependent upon the student conducting themselves in a respectful and supportive manner to
other members of their on-line learning community.
The VLE is a closed learning environment. It is the responsibility of each member of the leaning community to
maintain this environment. Usernames and passwords assigned to students for electronic resources are for the use
of that student only and should not be passed to non-members of the Learning Net. Failure to comply with this
restriction can result in the withdrawal of such resources.
If the student decides to leave their programme of study prior to its completion then PDF must be informed by letter
sent to the Norwich Office. Email or verbal notification will not be acceptable. This requirement comes into effect as
soon as an application form has been received from the student.
Middlesex University’s academic year is divided into two semesters. If an student leaves their programme prior to
completion of their studies then some portion of their fees may be refundable subject to the following conditions:
a. If the student leaves the programme within the second semester of the year no fees will be refunded
b. If a student leaves the programme within the first semester of the year then half of the fees will be
refunded minus £300 to cover initial set up costs of the electronic resources.
If the period of study extends beyond that specified by the students programme then PDF may charge additional
fees for every additional semester until the final submission and assessment has been completed. The student
should contact the Academic Advisor for details of these additional fees.
In addition to the terms and conditions outlined here all students agree to abide by those of Middlesex University
(available on MDX website) in regard to conduct of their studies.
Please sign below to show that you have read and agree to abide by these terms and conditions
Name:
Signature:
Date
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