BE PG Scholarship Application Form 09.

doc

School of the Built Environment

Postgraduate Scholarship Scheme

Application Form for

□ Full-time UK/EU School Scholarship □ Part-time UK/EU School Scholarship
□ Full-time Indian School Scholarship

□ Full-time Hodgkinson Scholarship

□ John Henry Brookes Scholarship

□ Jon Snow Scholarship (DEP applicants only)

□ Martin Wilkinson Fund Scholarship (DEP applicants only)

□ Brookes Africa Scholarship Scheme (DEP applicants only)

□ Robert Adam Architects (IARD applicants only)

□ Jones Lang LaSalle (IRE applicants only)

(Please tick all of which you are applying)

1. DETAILS OF MASTERS DEGREE PROGRAMME Please read scholarship detail leaflet before completing form
Title of Programme: Proposed start date:
(mm-yyyy)
Mode of study: Full-time □ Part-time □ Duration of programme: 1 year □ 2 years □

2. PERSONAL DETAILS
Title (eg Mr/Ms/Miss/Mrs etc): Male □ Female □ Please tick
Surname/ Nationality:
Family Name:
First Name: Country of domicile/
Area of permanent residence:
Address for correspondence: Home address (if different):

Postcode: Postcode:
Tel: Tel:
*Email: Email:

*Email is our preferred method of communication therefore please print your address clearly
BE PG Scholarship Application Form 09.doc

3. YOUR EDUCATION (including professional qualifications and training programmes)

Dates (from-to) Institution (include location) Subject(s) Result & Classification
(eg BA Hons 2.1)

4. YOUR EMPLOYMENT/PROFESSIONAL EXPERIENCE/UNPAID OCCUPATIONS

Dates (from-to) Brief details eg job title, company name, main responsibilities

5. YOUR ENGLISH PROFICIENCY

If your main language is not English, please tell us about any English language qualifications which you hold:

a) IELTS score (the normal minimum requirement is 6 or 6.5, depending on the programme ……………………………………
b) TOEFL score (the normal minimum requirement is 550 or 600, depending on the programme ………………………………
c) Any other English qualification which you hold, or are about to take ………………………………………………………………

6. FINANCING YOUR STUDIES

Are you applying for any other funding to support your postgraduate studies?

Yes □ No □ If no, move to Section 7

If Yes: (a) Are you applying for any other

Scholarships/grants/awards? Yes □ Name of award making body …………………………………
(b) Are you applying for other sources of
funding, eg a loan or sponsorship? Yes □ Details …………………………………………………………..
BE PG Scholarship Application Form 09.doc

7. PERSONAL STATEMENT
(to be completed by all applicants - Hodgkinson Scholarship applicants must consult Selection Criteria in
scholarship detail leaflet)

8. DECLARATION

I confirm that, to the best of my knowledge, the information given in this form is correct and complete.

Signature ……………………………………………………………… Date ………………………………………….