CHECKLIST
Doctoral School
Academic Societies Fund
For Research Students
Has any supporting documentation been
attached?
Has the form been signed by the Applicant,
Departmental Graduate Tutor and Head of
Department?
Application Form
Please read the Regulations carefully before completing this form. Please type or complete in BLOCK capitals.
1. Graduate Society Details
Name of Society:
Organisers:
Name
Department
Current Degree
Date of Registration
Full or Part-Time
2. Previous Awards
Please list all previous funding awards made by the Graduate School/Doctoral School to this Society:
Award Reference No. (or date of application)
Amount received
£
3. Proposal
Academic year to be covered by award:
Date from:
To:
Please list the uses to which this funding will be put and state how your request is relevant to graduate students:
www.ucl.ac.uk/docschool
4. Estimated Costs & Contributions
Expenses: (please give details)
£
Total Estimated Expenses:
£
Assured contributions (please give details where necessary):
Departmental contribution (please ensure amount has been arranged with the department/s concerned):
£
Amounts assured from other organisations (please give source and amount):
Applicants are advised to apply to external bodies, where appropriate.
£
Personal contribution:
£
Total Assured Contributions:
£
Amount Requested from Doctoral School:
£
Contributions requested but not yet assured:
Organisation applied to:
Date of decision:
Signature of applicant
(please state your membership role):
Date:
.00
Amount requested:
APPLICANTS: Please pass this form to your Department Graduate Tutor and Head of Department for endorsement.
www.ucl.ac.uk/docschool
5. Departmental Graduate Tutor’s Endorsement
Society Name:
Department:
Full name of Departmental Graduate Tutor (please print):
Departmental Graduate Tutor’s department (for correspondence):
Email:
Tel:
Supporting Statement:
Signature of Departmental Graduate Tutor:
Date:
6. Heads of Department’s Endorsement *
We support this application:
strongly
moderately
 A statement is required.
The Department/s is/are willing to contribute:
Matching contributions from the department/s or other sources will be expected.
£
Head of Department/s Signature:
(* May include the HoD’s appointed representative).
Date:
Name (please print):
Ext:
NOTE TO DEPARTMENTS:
1. Please see CHECKLIST on front of form before submitting the application.
2. Please submit by the deadline stated in the regulations to: Doctoral School, North Cloisters, UCL, Gower Street,
London WC1E 6BT
www.ucl.ac.uk/docschool