PEMBROKE COLLEGE
INTERNATIONAL PROGRAMMES
CAMBRIDGE CB2 1RF
Telephone + 44 (0)1223 338143
SPRING SEMESTER Programme
APPLICATION FORM FOR STUDY AS A ONE-SEMESTER UNDERGRADUATE
AT PEMBROKE COLLEGE, UNIVERSITY OF CAMBRIDGE
INSTRUCTIONS
This is an application form for a place to study at Cambridge from January 2017 to June 2017. The term
dates for 2017 are:
Lent term: Tuesday, 17th January – Friday, 17th March
Easter term: Tuesday, 25th April – Friday, 16th June
You should arrive on the Sunday preceding the start of full Lent term (Sunday, 15th January). The last
week of Easter Term, known as 'May Week', despite it being in June, is famous for its parties, concerts,
college balls and garden parties so you should plan to leave at the end of this week (Friday 23rd June).
First night of accommodation: Sunday 15th January
Last night of accommodation: Thursday 22nd June
Applications open on 1st January 2016 and will be considered on a rolling basis. The closing date for
applications is 30th September 2016. You are encouraged to apply as early as possible, given the intense
competition for places.
Please be reminded students are expected to take courses in the subject area of their major. In addition,
you should note that you cannot take courses in the natural sciences, engineering, mathematics,
computer science, foreign languages, law, management or geography. Please note that your
choices will be taken as indicative and that a small number of Cambridge papers will not be available to
semester students.
Please complete the form electronically, print and send it to:
Lyndy Hilton
Spring Semester Programme
International Programmes
Pembroke College
Cambridge CB2 1RF
United Kingdom
Please fill in and pass to the first referee named on p.6, enclosing the documents requested. Ask the
referee to complete the questions on the back page and to send the completed form to the above address.
Note that we also require a second reference, to be sent to us in a sealed envelope, either with the
application or separately, to arrive by the same date.
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It is also necessary to provide two examples of written work that you feel are representative of your
abilities and that have been graded by your professor as part of your current course of study. These must
not be written specially for this application and must be graded by a faculty member.
Please also enclose an official signed and sealed academic transcript from your University with your
application.
PERSONAL DETAILS
Surname (family name):
First Name:
Full Name on Passport:
Date of Birth (day, month, Year):
Sex:
Marital Status:
Name and address of next of kin:
Place & Country of Birth:
Nationality:
University email address:
Personal email address (for example, Gmail):
Your email address for correspondence: University/ Personal (please circle)
Country of residence since October 2013 (other than merely for educational purposes):
Current university (plus campus if applicable):
Country that you will return to when you have completed the programme:
Current overall GPA:
Major (if decided):
Current GPA in major:
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Home address:
University address:
Your address for correspondence: Home/University (please circle)
Contact details for University International Office (if applicable):
ACADEMIC DETAILS
Please enclose an official signed and sealed academic transcript from your University.
Qualifications in the English language (if this is not your native language):
Dates of attendance at school and university (since age 13):
Name of Institution
From
To
Expected date of graduation from university:
What credits, if any, do you need to obtain during your proposed study in Cambridge?
You should not apply for a similar place for this period at any other Cambridge College. Please indicate
this is the case by ticking the box below.
 I confirm that I am not applying for a similar studentship for this period at any other Cambridge
College.
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FUNDING DETAILS
Please state your funding arrangements:
Name of scholarship or other scheme supporting application (where relevant, please attach details of the
history and nature of the scheme):
Level of support expected from it:
Estimated date by which you will know if you will get this support:
Person/Institution responsible for paying Accommodation:
Email:
Person/Institution responsible for paying Tuition:
Email:
FURTHER DETAILS
Why do you wish to study at Cambridge?
Which courses of study, among those available in Cambridge, particularly attract you? Give reasons.
Please be reminded students are expected to take courses in the subject area of their major. In addition,
you should note that you cannot take courses in the natural sciences, engineering, mathematics,
computer science, foreign languages, law, management or geography. Please note that your
choices will be taken as indicative and that a small number of Cambridge papers will not be available to
semester students.
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Please give information about the level and content of courses you have taken which are relevant to your
intended programme of study.
Outline your plans for the remainder of your university course, and for your career.
Please note that fees are non-refundable, apart from in exceptional circumstances which are not
coverable by insurance, and which the College will consider at its discretion. By signing this agreement,
you are agreeing to these terms and conditions.
Signed:
Date:
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ACADEMIC REFERENCE
Please indicate the names and addresses of two referees familiar with your university work. One, who
should be a member of staff in the Faculty or Department in which you are enrolled, should complete the
rest of the form; the other should write to us directly in support of your application. The final deadline for
all supporting documentation is 30th September 2016.
First Referee
Name:
Address:
Second Referee
Name:
Address:
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ACADEMIC REFERENCE
Please ask your first referee to answer the following questions and having done so to mail the form to:
Lyndy Hilton
Spring Semester Programme
International Programmes
Pembroke College
Cambridge, CB2 1RF
United Kingdom
Name of Applicant:
Do you support this application?
Please comment in detail on the candidate's academic achievement to date, commitment, capacity for
independent study, and suitability for the course of study proposed on this form.
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What qualifications, examination passes, or other credits, if any, do you require the candidate to bring
home from the period of study in Cambridge?
Signed:
Name:
Position:
Date:
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