Department of Infection, Immunity and Inflammation Departmental Graduate Studies Committee Application from Supervisor to Accept a Postgraduate Research Student To be submitted to Michelle Moore when completed People Name of Supervisor: Job title: Date of expiry of contract (if applicable): Number of current postgraduate students being supervised (including students being co-supervised): Name of Student: Date of Birth: Education (degree(s) awarded, date, class, University): Relevant employment or other experience: Where English is not the first language, what level of qualifications have been obtained? N.B. Generally the student will make formal application to the University through the usual channels. This will be using the standard form supplied through the Graduate Admissions Office. If this has been received by the department (Postgraduate Tutor) it will be available to the DGSC for consideration along with this form. Degree All postgraduate students initially are registered for an Advanced Postgraduate Degree (APG) but please state below the intended final degree to be studied. PhD MPhil MD Project Working title of project: Short description of the project, including hypothesis, and methods to be used (150-200 words): Does the project or student require an animal licence? YES/NO Does the project require Research Ethics Committee Approval? YES/NO Has this been obtained? (give date) Please state precisely how the project is to be funded, e.g. is the student: Overseas student EU student Home student Employed by the University Who is paying the tuition fees? What bench fees are you requesting? Who is funding these? What other resources can be provided by the supervisor (e.g. laboratory space, equipment, technical support)? Which colleague(s) would you suggest should be on the Progress Review Panel for this student? Signature of Supervisor……………………………………………………… Date…………………… FOR USE BY DEPARTMENTAL GRADUATE STUDIES COMMITTEE Comments on the application, including details of any amendments or clarification that is required: Decision of the DGSC: Approve, subject to meeting University requirements for fees, references, and English qualifications Reject (document the reasons for this) Amendments or clarification sought If approved, who will be asked to join the Progress Review Panel? Signed by Chair of DGSC………………………………………………… Date…………………… If approved: copies to supervisor, members of Progress Review Panel, Graduate Admissions Office, and Michelle Moore for filing. If not given full approval, copies to supervisor and Michelle Moore.