"Judge Business School MBA - Applying - The Application Form (DOC)"
Application for the Executive MBA Programme starting September 2010 1. PERSONAL DETAILS Family name: Date of birth (DD/MM/YYYY): Given name(s): Country of birth: Preferred name: Country of current residence: Gender: Please select: Principal nationality: Marital status: Please select: Secondary nationality: Please give details of any special need, disability or illness that you would like us to be aware of: 2. CONTACT DETAILS Contact address (where we can notify you of the decision on your application): Address: Home phone: Address: Mobile phone: Address: Business phone: Country: Primary e-mail: Postcode: Other e-mail: Permanent address (where you live, if different from your contact address): Address: Address: Address: Country: Postcode: 3. GMAT Date taken: Total score: Verbal %: Quantitative %: AWA score: The GMAT helps us to assess your preparedness for the Executive MBA, by testing your verbal, quantitative and analytical writing skills. If you can provide us with alternative evidence of these skills and would like to request a waiver from the GMAT please tick the box below and write a brief explanation of where you have used these skills. I request a GMAT waiver: Please provide a brief explanation of why you feel a waiver should be granted: 4. ENGLISH LANGUAGE PROFICIENCY If your first language is English, please tick here. IELTS Date: Average score: TOEFL Date: Score: TWE Score: If English is not your first language, but you are fluent and would like to request that we waive the requirement to take an English language proficiency test, please tick the box below and briefly explain why you should be granted a waiver. I request an English Proficiency waiver: Please provide a brief explanation of why you feel a waiver should be granted: 5. EDUCATION List all universities and colleges attended, starting with the most recent. Include courses you attended but for which you did not receive a degree. Indicate your rank within your cohort if possible. Dates From To Name of Institution & Major Degree Result Rank Full/Part Time MM/YY MM/YY Location Subject Awarded (Degree Class/GPA) / Please select: / Please select: / Please select: / Please select: Awards, Honours or Distinctions Date Name of Award / Prize Reason for Award Level of Competition / Significance 6. CAREER OVERVIEW Total Years of full-time post-graduation work/military experience you will have completed by 31 August 2010: Years Staring with your current/most recent position, list your employment and other activities since starting your degree(s). Include periods when you were unemployed, in military service, parenting or travelling. From To Company Job Title Activity Country MM/YY MM/YY Professional Qualifications Date Name of Awarding Body Subject Qualification 7. CURRENT FULL-TIME EMPLOYMENT Company name: Job title: Office location: Number of employees: Company description: Employed since: Current salary: £ per year Bonus: £ Number of staff supervised: Starting salary: £ per year Bonus: £ Promotions: Will you be staying with this employer for the duration of the EMBA? Yes No Will this employer contribute to your EMBA fees? Yes No Job Function Industry Sector (Please tick one box only) (Please tick one box only) Business Development CONSULTING: General INDUSTRY: Consumer Goods Consulting CONSULTING: Technology INDUSTRY: Electronics Corporate Planning/Strategy CONSULTING: Operations INDUSTRY: Energy / Utilities Entrepreneur CONSULTING: Strategy INDUSTRY: Internet and eCommerce Finance FINANCE: Asset Management INDUSTRY: Technology General Management FINANCE: Commercial and Retail Banking INDUSTRY: Legal HR FINANCE: Hedge Funds INDUSTRY: Manufacturing Legal FINANCE: Financial Services INDUSTRY: Media/Entertainment Marketing & Sales FINANCE: Insurance INDUSTRY: Healthcare/Pharma/Biotech Operations FINANCE: Real Estate INDUSTRY: Professional Services Project Management FINANCE: Investment Banking INDUSTRY: Raw materials Research & Design FINANCE: Venture Capital / Private Equity INDUSTRY: Retail Technology Management FINANCE: Wealth Management/Private Banking INDUSTRY: Sports / Leisure Other INDUSTRY: Advertising INDUSTRY: Telecoms INDUSTRY: Aerospace INDUSTRY: Transportation/Logistics INDUSTRY: Automotive OTHER: Not-for-profit/NGO INDUSTRY: Chemicals OTHER: Public Sector INDUSTRY: Construction OTHER: Research/Education OTHER: Previous roles/ promotions and dates (MM/YYYY), e.g. Junior Analyst to Analyst (03/2004), Analyst to Associate (05/2006): Describe your primary job responsibilities (including type and size of internal and external teams with which you work or supervise; type and number of clients or projects you manage; size of budget or revenue for which you are responsible; international contact): What is your most significant current challenge? What is your most significant accomplishment? PREVIOUS FULL-TIME EMPLOYMENT (Complete if applicable) Company name: Job title: Office location: Number of employees: Company description: Employed since: Starting salary: £ per year Bonus: £ Number of staff supervised: Final salary: £ per year Bonus: £ Promotions: Date and reason for leaving: 8. CAREER OBJECTIVES A) Describe your career progression to date. What have been the key milestones and/or turning points? What decisions and choices brought you to your current role? (Please do not exceed 200 words.) B) What is your long term career vision and how will an Executive MBA help you to achieve it? (Please do not exceed 200 words.) 9. FINANCE Please indicate how you intend to finance your Executive MBA fees/living expenses. Your funding will not impact the admission decision. Personal Savings % Employer Sponsorship % Bank Loans % Scholarships % Salary Sacrifice % Other Please list any scholarships that you have already been awarded for your Executive MBA study: Please list any scholarships for which you have applied, or intend to apply: 10. PERSONAL Activities and Interests: Please list the extra-curricular activities in which you are currently involved (e.g., sports, hobbies, family/parenting, clubs, associations, community activities, voluntary work, etc.). Activity Time spent per week Achievements / Positions of responsibility Which activity is most important to you and why? (Please do not exceed 100 words.) International Experience: Please list any significant periods growing up, living, studying or working outside your home country. Country Activity Duration (YY-MM) to to to to Languages: Please indicate all the languages you speak (including your first language) and your present level. Language Level How learnt English Please select: Please select: Please select: Please select: Level 0: Basic command of language needed in a range of familiar situations, e.g. can understand and pass on simple messages Level 1: Limited but effective command of the language in familiar situations, e.g. can take part in a routine meeting on familiar topics, particularly in an exchange of simple factual information. Level 2: Generally effective command of the language in a range of situations e.g. can make a contribution to discussions on practical matters. Level 3: Good operational command of the language in a wide range of real world situations, e.g. can participate effectively in discussions and meetings. Level 4: Fully operational command of the language at a high level in most situations, e.g. can argue a case confidently, justifying and making points persuasively. Level 5: Mother Tongue / Bilingual Next of Kin Please tell us who to contact in case of any emergency: Name: Address: Relationship to you: Address: Telephone: Address: E-mail: Postcode: Country: 11. ESSAYS: Please answer each of the following 3 essays, keeping each answer to 400 words: A) ‘When you can’t make them see the light, make them feel the heat’. Drawing on your own experience, what is the best way to get people to change their ways? B) What, in your view, are the most pressing global concerns? C) What do you most hope to learn from the Cambridge Executive MBA, and what will you contribute? 12. REFERENCES Please list the contact details of your referees: Professional (Line Manager / Supervisor) Referee Name: Job title: Organisation: Telephone: E-mail: If this is not your current line manager, please tell us why not and explain the relationship of the referee to you. It is very important that this referee has direct knowledge of you in a professional or work capacity): Peer/Team Member Referee Name: Job title: Organisation: Telephone: E-mail: 13. DECLARATION AND DATA PROTECTION This document forms the legal basis of your application to the University of Cambridge. We reserve the right to refuse admission or cancel an offer of admission in the event of any misrepresentation by you. Submission of an application does not imply an offer of admission. Read the following statement carefully before you sign the application. 1. DATA PROTECTION ACT (1998): I agree to the University of 2. I certify that all the information given in this application is Cambridge and colleges of the University of Cambridge processing complete and accurate. Details of qualifications and work personal data contained in my application papers, whether experience may be checked with the organisations and authorities provided in confidence or not by other individuals or institutions in concerned. I understand that any misrepresentation or omission of support of my application, as part of the admissions, registration information in this application may result in denial of admission, and funding processes. I recognise that some of the information cancellation of admission or expulsion from the MBA Programme, will have been received confidentially. I also agree that my and that the University of Cambridge may take legal action against personal data may be shared with scholarship or loan providers for me. the purpose of evaluating my eligibility for financial support. Should I be offered a place, I may be invited to participate in an online 3. I certify that I am the sole author of all the work submitted as community for admitted students, in which case my name and e- part of this application (including essays) except where clearly mail address may be sent to a third party supplier. I also agree to indicated otherwise. my contact information being sent to selected current and past 4. I understand that if my application is unsuccessful, the papers students of the Cambridge MBA in order to facilitate the sharing of relating to it will be destroyed and that the University will not return information about the MBA and Judge Business School. I also them to me. accept that, should I be made an offer of a place and subsequently register as a student of the University, my personal data will be 5. I hereby apply for admission to the Cambridge MBA. If I am retained during and following my studies for the purpose of offered and accept a place on the Programme I undertake to obey monitoring my progress and for the provision of anonymous the Statues and Ordinances of the University of Cambridge. statistical returns. I accept Date: By ticking this box you agree to all of the above statements and give your consent to the above terms.