ACADEMIC CASE FORM
(Postgraduate research programmes:
Collaborative Co-supervision / Split-site collaboration /
Off-site collaboration arrangements)
Confidential
EXPLANATORY NOTE
This form is used to seek academic approval to establish an agreement with a collaborative
partner. Parts A and B must be fully completed, please do not leave any blank sections.
Supplementary information should be attached where requested.
Before completing, please refer to the Code of practice for the approval and management of
collaborative provision.
Please complete the form in Word (i.e. type, do not handwrite).
Please note that incomplete or false information will lead to the termination of the process
and will result in the University not being able to progress the collaborative provision
proposal.
Part A: Summary Information
Proposer (name of individual):
Type your answer here
Faculty/Department/School:
Faculty:
School/Department:
Type your answer here
Proposed University
programme(s):
Programme code:
Type your answer here
Proposed start date:
Type your answer here
Period of Agreement:
Type your answer here
Professional/Statutory/Regulatory Type your answer here
Body (PSRB) approval (if
relevant):
If PSRB involvement specified in
Proposal form for collaborative
provision, please specify any
implications their involvement have
on the proposed arrangements may
have.
Relationship management:
Provide further information on the
mechanisms for managing the
relationship with the programme
team at the partner institution.
Type your answer here
Part B: Academic consideration
Academic rationale:
Please explain the academic
rationale for the proposed
collaborative partnership:
Type your answer here
Quality assurance:
Provide information on the quality
assurance processes in place at the
partner institution (for example, the
supervisory arrangements that will
be in place for the student and the
training and guidance given to
collaborative supervisors) and
length of time to be spent at each
institution: (500 words maximum)
Surrey:
Type your answer here
Partner institution:
Type your answer here
Confirmation
I hereby certify that the statements and information in this form are true and correct, and I
authorize the Directorate of Quality Enhancement and Standards/International Relations
Office to investigate all statements or other information contained in this form and any
attachments submitted with it.
Proposer
Name:
Signature:
Date:
Academic case approval
Chair (Faculty Research
Degrees Committee):
Chair (Faculty
Postgraduate Research
Director):
Signature:
Date:
Next stage:

Once the Business and Academic Case Form have been approved, the Directorate of
Quality Enhancement and Standards will inform Research and Enterprise Support Legal
Contracts who will liaise with the collaborative partner to proceed with the completion of
the appropriate agreement template.