NICR
Translational Prize Medical Student Bursary

Academic year 2015 - 2016
Personal details
Surname ________________________________________________________ Mr / Ms / Mrs / Miss /Dr
First name(s) (in full) ______________________________________ Nationality ____________________
Male

Female

Date of Birth: D D M M Y Y Y Y
YY
Address:
_____________________________________________________________________________________
_______________________________________________ Post Code: ____________________
E-mail address: __________________________________ Mobile Telephone No _____________________
The outcome of your application will be sent to this address
Academic Qualifications
Secondary Education
School and dates attended
Qualifications (highest level)
_________________________________________________________
_________________________________________________________
Subjects and grades awarded _________________________________________________________________
Tertiary Education
University and dates attended
Personal Statement
_________________________________________________________
_________________________________________________________
Subjects and grades achieved _________________________________________________________________

Personal Statement
Please give details of why you are applying for this award, in no more than 300 words. Provide evidence of academic ability, energy, commitment to cancer research and financial circumstances.
Career Aspirations
Please give details of your intended career, in no more than 150 words, and how receipt of an NICR
CRUK Translational Prize Medical Student Bursary will allow you to further your career.
Data Protection:
In order to conduct certain parts of its business, for example communicating with you as an applicant, monitoring recruitment campaigns, the University will need to retain personal data that you have supplied in this form. The retention of any data will be conducted in accordance with the Data Protection Act (1998) and will not normally be retained for more than two years. Please feel free to contact us if you wish to view the data that has been retained, or if you do not wish for any data to be retained.
Terms and Conditions:
Please note that you have an obligation to inform the University immediately of any change in your circumstances that have significance to your application.

Personal Tutor or Academic Supervisor Statement
Please give details of the suitability of this student for this award, in no more than 300 words. Please include your assessment of and provide evidence of the applicant’s academic ability and commitment to cancer research.
Tutor or Supervisor
Name ________________________________ Position ________________________________________
Signature _____________________________ Date ___________________________________________
Address:
_____________________________________________________________________________________
_______________________________________________ Post Code: ____________________
E-mail Address: _________________________________ Telephone No _____________________
Sign below to indicate that you have read and accepted the terms and conditions outlined below:
Signed Date
(Student)
THE DEADLINE FOR SUBMISSION OF THIS FORM IS 31 st JANUARY 2015

NI
Translational Prize Medical Student Bursary
NICR CRUK Translational Prize Medical Student Bursary
1.
Recipients must be registered as home students on the M.Res in Cancer Programme at
Newcastle University in the 2015-16 academic year.
2.
Award will be made after consideration of all relevant applications in competition.
3.
Successful applicants will be chosen to receive the awards on the basis of academic ability as evaluated by consistent high achievement in examination, evidence of commitment to cancer research the and overall quality of the application.
4.
Students who are funded from another source are not eligible to apply for these awards.
5.
Applications must be submitted by e-mail with the application form attached. Other applications will not be accepted.
6.
The deadlines for applications for the 2015-2016 academic year are 31 st January 2015 and 16 th July 2015.
7.
Awards will not be confirmed unless applicants satisfy all conditions related to the scholarship offer.
8.
The Institute reserves the right to vary all or any masters award at its discretion.
9.
At the end of the M.Res. in Cancer Programme, recipients must submit to the Institute a brief report that summarises how the award has helped them with their studies and the University transcript of their degree.
10.
If a student leaves the University before the end of the academic year or returns an unsatisfactory report, the Institute has the right to request that the award is refunded.
1.
The NICR Cancer Research UK (
CRUK)
Translational Prize Medical Student Bursary is awarded to an outstanding young medical student who studies the M.Res. in Cancer
Programme during their intercalation year.
2.
This Bursary is awarded on the basis of proven academic excellence in secondary and tertiary education.
3.
Applicants are expected to demonstrate a strong commitment to continued involvement
4.
in translational cancer research.
Awardees must undertake their research project under the supervision of designated academics within the clinical translational and drug development groups in the NICR.
5.
Applicants are expected to demonstrate that they have no alternative source of income to support their studies.
6.
One NICR
CRUK
Translational Prize Medical Student Bursary is available annually.
7.
The deadline for applications for the 2015-2016 academic year is 31 st January 2015.
8.
Each award is worth up to £2,000 and is payable in equal amounts in October and
March of the academic year directly to the awardee for use towards living expenses.