Application for Post-graduate Study

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Application for Postgraduate Study: Exchange/Visiting Student
Please complete all sections of this form and return it to the address shown on the letter
accompanying the form.
Information on this form will be held on computer and is protected by the Data Protection Act 1984.                                             Student number
Some information will be sent to the Higher Education Statistics Agency for use in statistical analysis.                                             (Office use only)

    Title:                        Surname/Family Name:
    (Mr, Ms, Mrs, Miss, Dr etc)
                                                                                                                                          Day                 Month             Year
    First Names:                                                                                            Date of Birth:
                                                                                                            Country of permanent
    Male/Female:                                    Nationality:

   1. Address for correspondence                                                                                 2. Permanent Address if different from Address 1

   Country (if NOT in UK)                                                                                        Country (if NOT in UK)
   or Postcode (if in UK)                                                                                        or Postcode (if in UK)
   Daytime Telephone:                                                                                            Daytime Telephone:

   Evening Telephone:                                                                                            Evening Telephone:
   Fax, Email or Telex                                                                                           Fax, Email or Telex if
   if available:                                                                                                 available:

   If you are to change addresses, please state when we should begin to write to you at Address 2:

   Your Proposed Date of Entry                                   Day:                      Month:                      Year:                    Study Mode: Part time/Full time/Modular
   Programme of Study /
   Area of Research           :


    REGISTRY                                                             NE/SE                             Lang                       QEvid                        How found:

                                      Medic                              Eth                               Dis                        MPhD                         EngD

    DEPARTMENT                    Time:                                          Date:                                 Interviewer:                                Lunch:

                                  Accept / Reject:                               Course Details - Title:                                                           Fee:

                                  Start Date:                                    End Date:                             Supervisor (if known):

                                  Signed:                                                                                                                          Date:

    Offer conditions (please tick)
                Financial                                   References                               English                 Qualifications                                 Other
                Guarantee                                                                                                    (please specify)                               (please specify)


             Dates Attended                               Name and address of School                             Qualification and Grades Achieved

HIGHER/PROFESSIONAL/VOCATIONAL EDUCATION (including current studies). If your qualification is not from a UK
university, please enter the actual title of the award (not its equivalent to the UK classification).

          Dates Attended                                                                    Subject(s) Studied      Qualification and        UK equivalent
                                              Name and address of Institution
   and whether full or part-time study                                                       or Degree Title        Grades Achieved        (Registry use only)

   Have you studied at Higher Education level in the UK before?                                         YES               NO             (please tick box)

   ENGLISH LANGUAGE QUALIFICATIONS: If English is not your first language, please give details of English language courses
   attended and qualifications attained. Please include (or send later) some evidence of your English language ability. IELTS is preferred,
   however if IELTS is unavailable then TOEFL is acceptable.
 Examining board/authority                        Exam title                                  Result                                    Date

              Dates                                  Post                                                               Brief Description of Duties
                                                                                    Name and address

                                                                                                                       (If necessary continue on a separate sheet)

FURTHER INFORMATION - Candidates are invited to include here relevant information for which no provision is made elsewhere
on this form, eg proficiency in other languages. An indication of career aspirations and motivation for following the programme of
study/research at Cranfield should be included.
     Please state below the names, addresses (and telephone number if known) of two referees.

       Referee 1:         Name                                                                              Referee 2:         Name

                          Address                                                                                              Address

                      Postcode                    Tel:                                          Postcode                         Tel:
                      Fax:                        Email:                                        Fax:                             Email:
     If a referee is your current employer and you do not wish, at this stage, to contact him/her, please do not write the name and
     address but enter 'current employer, do not contact yet'.

How will your fees and living expenses be financed? Please give full details of any sponsoring organisation(s) including letters of
sponsorship. Please note: if you are unable to secure sponsorship you will be personally liable for the full cost of the course.

EQUAL OPPORTUNITIES                                                                                  SOURCE OF INFORMATION
Cranfield University is committed to a policy of equal opportunity                                   How did you first find out about Cranfield (please tick box):
for all its students. Monitoring the composition of the student body
will help the University to take steps to ensure that it does not                                           From a current or former student                                                    1
discriminate. The information is used by the Department of
Education & Employment and the Higher Education Statistics                                                  From a Directory/Prospectus                                                         2
Agency. The classification used is in accordance with that used in
                                                                                                            From WWW page                                                                       3
the census.
Ethnic Origin                                                                                               From an advert                                                                      4
I would describe my ethnic origin as (please tick box):                                                     - please state newspaper/journal and the
     Pakistani                                32     Indian                                     31          advert code (if known)

     Bangladeshi                              33     Asian other                                39
     Black African                            22     White                                      10          From a Careers Office                                                           5
     Black Caribbean                          21     Black other                                29          Other (Please specify)                                                          6
     Chinese                                  34
     Other: (please specify)                  80
     Please tick the box which best describes your status with
     respect to any disability:                                                                      SUPPORTING INFORMATION
     No known disability                                                                       00    (please tick box)                                                     ENCLOSED              TO FOLLOW
     Dyslexia                                                                                  01    Transcript of overseas qualification
     Blind/partially sighted                                                                   02    Evidence of English language ability
     Deaf/have a hearing impairment                                                            03    Financial guarantee
     Wheelchair user/have mobility difficulties                                                04    References
     Personal care support                                                                     05
     Mental health difficulties                                                                06    Other: (please specify)
     Unseen disability, eg diabetes, epilepsy, asthma                                          07
     Multiple disabilities                                                                     08
     A disability not listed above                                                             09

     Is your disability
     A registered disability                                                                   02
     A disability which is not registered                                                      03

I declare that the information on this form is correct to the best of my knowledge and agree, if registering as a student, to abide by all of the University's
Signed:                                                                                                            Date:

Ad missions                                                                                          C ol l e g e of A er o na ut i c s an d B i ot ec h nol o g y C en t re
P os tg r ad u at e A dm i s s i o ns                                                                T el : + 44 (0 ) 1 23 4 7 5 41 5 7      F a x: + 4 4 (0 ) 1 2 34 75 2 46 2
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T el e p h on e: + 4 4 (0 ) 1 2 34 7 5 4 17 1                                                        E c o t e c hn ol o g y
F a x: + 4 4 (0 ) 1 2 34 75 2 46 2                                                                   R es e a rc h C e nt r e T el : + 4 4 (0 ) 1 23 4 7 5 41 5 5          F a x : + 4 4 ( 0 ) 1 23 4 7 52 4 62
E m ai l : re gi s t r y@ c r an fi el d. ac .uk                                                     S c h o ol of Me c ha ni c a l E n gi n e e ri ng an d S c ho ol o f Ma n a g em e nt
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