Africa Centre For Population Health PhD Studentship: Application Form 1. Name 2. University degrees / diplomas Degree Institution Year 3. Prizes (university level and above) Prize Institution Year 4. Employment history since undergraduate degree award (in reverse chronological order) Post Institution Dates 5. Intended career pathway Africa Centre PhD Studentship: Application Form December 2015 page 1 of 3 6. Relevant experience in low- or middle-income country settings (max 300 words) 7. Research training and experience (include any courses or specific training) Africa Centre PhD Studentship: Application Form December 2015 page 2 of 3 8. Publications (only items published or in press: do not include conference presentations) 9. Please indicate how you heard about this PhD studentship HAYA website via University departmental email Africa Centre website Other, please specify: 10. Please provide 2 references, using the Reference Form, at least one must be from an academic referee. Africa Centre PhD Studentship: Application Form December 2015 page 3 of 3