APPLICATION FOR ADMISSION AS A

POSTGRADUATE STUDENT
Please complete the form printing carefully in black ink. All questions must be answered. *Delete as applicable
(in BLOCK CAPITALS)
1. SURNAME or FAMILY NAME. …………………………………………………………….……………….. 2. TITLE (Mr, Mrs, Ms, Miss, Other). …………………………

3. FIRST, or given, NAMES. …………………………………………………………………………………………………………………………… 4. GENDER: Male/Female *

Have you previously applied for admission to Southampton SOLENT University as a postgraduate or undergraduate student? YES/NO *

5. HOME ADDRESS. (see note 1) 6. ADDRESS FOR CORRESPONDENCE if different. (see note 2)

……………………………………………… ………………………………………………… …………………………………………………………………………………………………………….…

…………………………………………………………………………………………………… ……………………………………………………………………………………………………………..

Postcode …………………………………………………………………………………… Postcode ……………………………………………………………………………………………….

Telephone Nos ……………………………………………………………………(day) Telephone Nos .……………………………………………………………………….…. (day)

………………………………………………………………………………….. (evening) ……………………..………………………………………………………………………. (evening)

Fax No. ………………………………………………………………………………………. Fax No …………………………………………………………………….…………………………….

E-mail ………………………………………………………………………………………… E-mail …………………………………………………………………………………………………….

7. SPECIAL NEEDS INDICATOR. (see note 3) 8. CRIMINAL CONVICTIONS. (see note 4)

Do you have a relevant criminal conviction?

9. DATE OF BIRTH. .…………………………………………………………………… 10. COUNTRY OF PERMANENT RESIDENCE. (see note 5)

Day/Month/Year
…………………………………………………………………………………………………………

11. PLACE OF BIRTH. (Country). ………………………………………………… 12. NATIONALITY. ……………………………………………….………………………………

13. UK RESIDENCY. (see note 6)

Date of first entry to live in the UK …………………………………… 13a. RESIDENTIAL CATEGORY (see summary sheet)
Day/Month/Year
14. ETHNIC ORIGIN. (see note 7) Asian
‰ Indian 31
White ‰ Pakistani 32
‰ White 11 ‰ Bangladeshi 33
‰ Chinese 34
Black ‰ Other Asian background 39
‰ Caribbean 21
‰ African 22 Mixed
‰ Other black background 29 ‰ White and Black Caribbean 41
‰ White and Black African 42
Other ethnic background ‰ White and Asian 43
‰ Other ethnic background 80 ‰ Other mixed background 49

15. FUNDING. (see note 8) 16. ENGLISH LANGUAGE PROFICIENCY REQUIREMENT.

Who will be paying your fees? Employer/Sponsor/Yourself* Is English your first language? YES/NO *

Name and address: …………………………………………………………………… If ‘No’, in which language has most of your education been taught? (see
note 9)
…………………………………………………………………………………………………….

……………………………………………………… Postcode …………………………… ………………………….…………………………………………………………………………

Telephone/ Fax No. ……………………………………………………………………

17. FACULTY. To which FACULTY of Southampton SOLENT University are you applying? (see note 10) FMAS FTEC SBS WMA

18. For which COURSE/PROGRAMME are you applying? Postgraduate Taught Course MPhil only MPhil/PhD PhD only
(see note 11) □ □ □ □

Please give COURSE TITLE or AREA OF RESEARCH ……………………………………………………………………………………………………………………………………

19. MODE OF STUDY. (see note 12) Full-time Part-time Distance learning
Indicate which mode you wish to study

20. DATE OF ADMISSION. (see note 13)

Please state the academic year in which you wish to begin your course ……………………………………………………………………………………………………
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21. TRANSCRIPTS. Please give full details of your education since the age of 14 starting with the most recent (see note 14).

Qualifications obtained.
School, College or Dates of Where appropriate state class of degree,
University. attendance date of award and, if English is not your Grades Main subjects
State country first language, give details of any English
if outside the UK language qualifications obtained

22. WORK EXPERIENCE. (see note 15)

Please give details of career history and list any professional qualifications obtained starting with the most recent.

Name and address of employer Dates Position held/qualifications obtained

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23. PREVIOUS RESIDENCY. State all the countries (including the United Kingdom) in which you have resided during the last ten years. This information is
ESSESNTIAL for the processing of your application. Please note that writing ‘Not Applicable’ will not be acceptable.

Country Dates Country Dates

24. REFERENCES. (see note 16)

State the names and addresses of the two people who have provided references on the confidential reference forms that you are returning with this applic
form.

Name and title ……………………………………………………………………………………… Name and title ………………………………………………………………………………………

Position held ……………………………………………………………………………………… Position held ………………………………………………………………………………………

Address …………………………………………………………………………………………………. Address ………………………………………………………………………………………………….

…………………………………………………………………………………………………. ………………………………………………………………………………………………….

……………….………………………………………………………………………………… ……………….…………………………………………………………………………………

Postcode ……………………………………………………………………………………………… Postcode ………………………………………………………………………………………………

Telephone No. ……………………………………………………………………………………… Telephone No. ………………………………………………………………………………………

Fax No. ………………………………………………………………………………………………… Fax No. …………………………………………………………………………………………………

E-mail …………………………………………………………………………………………………… E-mail ……………………………………………………………………………………………………

25. AVAILABILITY FOR INTERVIEW.

Some Faculties may wish to interview candidates who are UK based. Faculties may also require overseas students to be interviewed in their home
country. Please indicate any periods when you might NOT be available for interview.

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

26. SUPPLEMENTARY PERSONAL STATEMENT. On a separate sheet please attach a description of your academic interests and reasons for applying for this
course of study, giving details of any other experience which may be relevant to the course and your application, and a list of your publications if
applicable.

Please note: if you applying for admission as a Research Student (MPhil/PhD) you should also attach a Research Proposal of approximately 1000
words.

27. DECLARATION BY APPLICANT. (See note 17)

I confirm that the details contained in this form are correct to the best of my knowledge.

In accordance with the Data Protection Act 1998, I understand that personal information about me will be used for personnel and administrative
purposes and statutory returns. This information may also be transmitted and displayed on an internal network for relevant Southampton SOLENT
University business purposes.

Signature of Applicant ………………………………………………………………………………………………………………………………………… Date ………………………………………

3 of 4 ASQS July 2008/AJG

Southampton SOLENT University

Criminal Conviction

The University has a responsibility to provide a safe educational environment for its students and staff. For this reason all applicants seeking
admission to the University’s courses are required to declare any relevant criminal convictions that they may have so that appropriate checks
can be made.

Relevant criminal convictions are only those convictions for offences against the person, whether of a violent or sexual nature, and convictions
for offences involving unlawfully supplying controlled drugs or substances where the conviction concerns commercial drug dealing or trafficking.
Convictions that are spent (as defined by the Rehabilitation of Offenders Act 1974) are not considered to be relevant and you should not reveal
them (but see the next paragraph below).

If you are applying for courses in teaching, health, social work and courses involving work with children or vulnerable adults, you must tell
us about any criminal convictions, including spent sentences and cautions (including verbal cautions) and bind-over orders. For these
courses, you may need an ‘enhanced disclosure document’ from the Criminal Records Bureau. You may find the information below
useful.

England & Wales Criminal Records Bureau http: www.crb.gov.uk

Courses in teaching, health, social work and courses involving All other courses
work with children or vulnerable adults

For these courses, you must declare YES if any of the following For these courses, you must declare YES if any of the following
statements apply to you: statements apply to you:

a. I have a criminal conviction a. I have a relevant criminal conviction that is not spent
b. I have a spent criminal conviction
c. I have a caution (including verbal caution) b. I am serving a prison sentence for a relevant criminal
d. I have a bind-over conviction
e. I am serving a prison sentence for a criminal conviction

If statement e applies to you then you must also give the prison
address as you postal address on page 1 of your application and a If statement b applies to you then you must also give the prison
senior prison officer must support your application. address as your postal address on page 1 of your application and
a senior prison officer must support your application.

Convictions that are spent (as defined by the Rehabilitation of

Offenders Act 1974) are not considered to be relevant and you
should not reveal them.

Applicants who answer YES will not be automatically excluded from the application process. However, the Student Affairs Manager may want
to consider the application further or ask for more information before making a decision.

If you are convicted of a relevant criminal offence after you have applied you must tell Southampton SOLENT University. Please contact
the Student Affairs Manager for further details.

ASQS July2008/AJG

Please return this form with other papers (see note 17) to the relevant Faculty address as shown in Faculty Contact Details overleaf.

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 FACULTY CONTACT DETAILS

If you still have any queries, please telephone or Email the Faculty Admissions Office to ask for specific advice.
Otherwise you should send your completed application to the relevant Faculty Admissions Office as shown below.

Faculty Registry Office Faculty Registry Office Faculty Registry Office Faculty Registry Office
Faculty of Media, Arts & Society Southampton Business School Faculty of Technology Warsash Maritime Academy
Southampton Solent University Southampton Solent University Southampton Solent University Newtown Road
East Park Terrace East Park Terrace East Park Terrace Warsash
Southampton Southampton Southampton Southampton
SO14 0RF SO14 0YN SO14 0RD SO31 9ZL

 023 8031 9171  023 8031 9133  023 8031 9975  01489 556241
[email protected] [email protected] [email protected] [email protected]

FOR UNIVERSITY USE ONLY

Recommendation of Admissions Tutor.

This part should be duly completed by the appropriate Admissions Tutor, and returned to the Faculty
Admissions Office.

Name of Applicant

Course Year

1. Accept without condition

2. Accept subject to

(a) Examination Results (specify)

(b) Personal Interview

(c) Any other conditions

3. Unsuccessful because

Signature of Admissions Tutor

Name (please print) Date

 Notes on how to complete the Application Form

Note 1
This address in the one the University will use for future correspondence unless an alternative correspondence address is given.

Note 2
A correspondence address is required if you want post to be sent to any address other than your home address. If you are an
Overseas student you should normally enter your overseas address as 'Home Address', and enter under 'Address for
Correspondence' the address where you may be contacted while in this country.

Note 3
The University welcomes applications from people with a disability or special needs. If you have ticked this box and your
application is successful you will receive a letter inviting you to discuss any support needs with the Learning Support Staff.
Please enter a code from the following list:

0 No disability/awareness of additional support requirements in study.

1 Specific learning difficulties (e.g. dyslexia).
2 Blind/partially sighted.
3 Deaf/hard of hearing.
4 Wheelchair user/mobility difficulties.
T Autistic Spectrum Disorder/Asperger’s Syndrome.
6 Mental health difficulties.
7 Unseen disability (e.g. diabetes, epilepsy, heart condition).
8 Two or more of the above disabilities/special needs/medical conditions.
9 Disability/special need/medical condition not listed above.

Note 4
The University has a duty of care to provide a safe educational environment for its students and staff. For this reason all
applicants seeking admission to the University’s courses are required to declare any relevant criminal convictions that they may
have so that appropriate checks can be made. Please also refer to the back sheet of the form, called ‘Criminal Conviction’.
(Page 4 of the electronic version). Any information you provide will be treated as strictly confidential.

Note 5
Country of permanent residence. This is the country in which you are normally permanently resident.

Note 6
If you were born outside the UK but now live in the UK, please give the date when you began living here permanently.

Note 7
The University is keen to increase the number of students from Ethnic Minorities who apply for courses. In order to ensure that
we are reaching all the groups who are interested in our courses, please assist us by completing the Ethnic Origin section.

Note 8
If you have indicated an employer or other sponsor, an invoice will be sent direct to them at the address given. However, if you
work for a department of your company and the invoice should go to the Head Office please give details in the space provided.
You should enclose a letter from your sponsor or a completed Employer Guarantee Form indicating that your
sponsor/employer has agreed to pay the fees. If you are paying your own fees, payment must be made at the University
Student Accounts Office at enrolment. Self-funding students will normally pay in two installments. Payments can be made by
cash, cheques made payable to Southampton Solent University, or by Debit/Credit Card.

If you are paying your own fees, payment must be made at the Southampton SOLENT University Student Accounts Office upon
enrolment. Self-funding students would normally pay in two installments. Payment can be made by cash, by Debit/ Credit Card
or cheques made payable to Southampton SOLENT University.

Funding for Postgraduate Taught Courses

The University normally has some bursaries for certain postgraduate taught courses. Please see our Prospectus for Financial
Advice, talk to our ‘Students 1st’ Service or visit our website on: www.solent.ac.uk/hellouni.

If you have been awarded a scholarship from another source, please give full details, including the name of the awarding body,
your reference number (if applicable), the duration and value of the award, and the terms and conditions of your scholarship
(with translation if appropriate).

Note 9
Applicants whose first language is not English, or who have not received their higher education in English, will be required to
produce evidence of their English language proficiency. They should provide details of English language qualifications obtained
and details of any results pending. As a general guide, applicants should have achieved a minimum IELTS (International English
Language Testing System) score of 6.5, a TOEFL (Test of English as a Foreign Language) score of at least 600 (paper-based), 250
(computer-based), or 100 (internet-based). Applicants should be aware that this is a minimum requirement. Some courses
require a higher level of proficiency. Applicants who wish for further guidance on English language requirements should contact
the University directly.
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Note 10
There are four faculties in Southampton SOLENT University:
‰ FMAS Faculty of Media, Arts and Society
‰ FTEC Faculty of Technology
‰ SBS Southampton Business School
‰ WMA Warsash Maritime Academy

Note 11
Please see our Postgraduate Prospectus for details or visit www.solent.ac.uk/postgraduate/postgradstudy.aspx
The University reserves the right, at its discretion, and for any reason, to make changes to the courses offered without prior
notice, and in particular, not to offer:
A scheme of study which fails to recruit the minimum number of students required by regulations or
options, units or specialisms within a scheme of study, where there is insufficient demand.
If applicants are particularly concerned about the detailed elements of a course being offered, they should contact the relevant
faculty office to check the course details, prior to accepting an offer of a place on the course.

Note 12
Please note that if you are from outside the EU (European Union) and enter the UK on the basis of a Student Visa, you can only
apply for full-time studies.

Note 13
Taught Courses normally begin at the end of September. However, some courses (e.g. the University’s MBA programme) may
also admit students in February.
The Research Training Course for Research students commences at the end of September each year. It is, therefore, sensible
for Research students to commence their studies at the end of September. Although, it is possible to negotiate a different start
date (please discuss this with your Director of Studies).

Note 14
Please note that we need copies of all relevant Diplomas/Certificates and transcripts. Please list all qualifications/degrees
(relevant to the course of study for which you are applying) and the last school/college/university you attended along with dates
of attendance. Please do not send original documents. Documents must be in English and certified as a true copy. This
certification may be obtained from a Solicitor or the British Council.

A transcript is a detailed statement which confirms the award of your qualification/degree and also lists all the subjects studied
and grades obtained.

Note 15
Details of work experience that may be relevant to the course of study for which you are applying.

Note 16
You should give the names of your referees on your application form for record purposes.
All applicants are required to submit two reference letters. Please find the attached two ‘Request for Confidential Reference’
forms. State your name, academic year of entry and the course you wish to be considered for and pass them to your referees.
After completing their part, your referees should sign across the envelope seal. Please submit both the Reference letters
together with your application.

The referees must normally be people who are familiar with your academic work. However, if your most recent academic study
was several years ago, and you feel other experience is more relevant, then other types of referee may be used (e.g. your
current employer). The University reserves the right to ask for additional references.

Note 17
You are asked to submit ALL the required documentation with your application. COMPLETE APPLICATIONS will include:
‰ Application form;
‰ 2 Reference letters;
‰ Transcript(s);
‰ Evidence of English Language proficiency (if appropriate);
‰ Research Proposal (for Research Applicants only);
‰ Employer Guarantee Form (where appropriate).

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RESIDENTIAL CATEGORY (COMPILED WITH THE HELP OF UKCISA)

Summary of residential category codes

A You are a UK or EU national, or are the child of a UK or EU national, and have lived in the
European Economic Area (EEA) or Switzerland (or both) for three years, but not mainly for the purpose
of full-time education. If you are a UK national, you may have also lived in the Channel Islands or the
Isle of Man (or both) during these three years.

B You have Indefinite Leave to Enter or Remain in the UK or have the Right of Abode in the UK and
have lived in the UK, the Channel Islands or the Isle of Man (or more than one of these) for three years,
but not mainly for the purpose of full-time education. However, this does not apply if you are exempt
from immigration control, for example, as a diplomat or a member of visiting armed forces or an
employee of an international organisation or the family of such a person. If this is your situation, your
residential category is O.

C You are a refugee, or have been granted Exceptional Leave to Enter or Remain, Humanitarian
Protection or Discretionary Leave in the UK following an application for asylum, and you have lived in
the UK, the Channel Islands or the Isle of Man since that status was recognised or granted, or you are
such a person’s husband, wife or child.

D You are an EEA (but not UK) or Swiss national, you live in the UK and you are a migrant worker (or
you are such a person’s husband, wife, civil partner or child), and you have lived in the EEA or
Switzerland (or both) for three years, but not mainly for the purpose of full-time education.

G You would otherwise meet the criteria of categories A, B, C or D, but you have been living outside
the UK, Channel Islands, Isle of Man, EEA or Switzerland (or more than one of these) because you, your
husband or your wife or your parent have been temporarily working outside the area in question.

O Other.
REQUEST FOR CONFIDENTIAL REFERENCE for
POSTGRADUATE STUDENT of
Southampton SOLENT University
East Park Terrace
Southampton
SO14 ORR
UK

TO THE CANDIDATE APPLYING FOR ADMISSION AS A POSTGRADUATE STUDENT

Please complete sections A, B and C below before sending the form and envelope to each of the referees you have
named on your application form.

A. Full Name (Please underline Surname/Family Name): ………………………………………………………………………………………………………

B. Proposed Degree and Course title/ Field of study: ……………………………………………………………………………………………………………

C. Academic year in which you hope to start the programme (e.g. 2008/2009): …………………………………………………………………

TO THE REFEREE

The person named above has applied for postgraduate study at Southampton SOLENT University, and has given your
name as a referee. I should be grateful if you would provide, as soon as possible and in English please, a confidential
opinion on this candidate’s personal and academic suitability for the proposed study.

This form is divided into two sections. The first section asks you to grade the candidate against a number of criteria.
Please complete as much of the questionnaire as possible, as this information will be of great help to us in considering
the application. You may find, however, that certain questions require a detailed knowledge of the candidate’s
academic work (Questions 13 -15, for example). If you do not feel able to respond to some of the questions, please
leave them blank.

The second section allows you to give any other useful information. You should comment here on the candidate’s
personal academic suitability for the proposed study.
If the candidate has yet to complete a first degree or other qualification, I would appreciate some indication of the
class or grade of award you expect him or her to obtain.
For applications for a Master of Business Administration (MBA) programme, or similar vocational Masters’ programme, it
is particularly important to comment on the candidate’s employment experience and professional competence.

Would you please use the space on the back of this form and return it direct to the candidate, sealed in an envelope,
and signed across the seal. The candidate will forward the application form together with the sealed reference to
Southampton SOLENT University. Allowing the candidate to assemble and submit references in this way greatly speeds
up the application process.

If, however, you are unable to comply with this request, would you please return the reference direct to me, marking
the envelope “Confidential”. You should inform the candidate if the reference is sent directly to Southampton SOLENT
University.

Thank you for your help.

Faculty Registrar

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 CONFIDENTIAL STATEMENT BY REFEREE

Section 1. QUESTIONNAIRE

1. How long have you known the candidate? ……………………………………………………………………………………………………………………………………

2. In what capacity do you know the candidate? (E.g. tutor/employer) …………………………………………………………………………………………

INTELLECTUAL SKILLS Very good Good Satisfactory Poor

3. Numeracy

4. Ability to analyse and synthesise material from a range of sources

5. Fluency in articulating an argument

6. Information retrieval and presentation skills

7. Originality of interpretation

8. Sense of enquiry and ability to generate research hypotheses

9. Ability to contribute to the life and work of the academic or

professional community

PERSONAL QUALITIES Very good Good Satisfactory Poor

10. Conscientiousness

11. Perseverance

12. Time management and organisation skills

13. Ability to work alone

14. Ability to work as part of a team

15. Ability to work under pressure

16. Health

17. Ability to pursue his/her own initiative

Section 2. FURTHER COMMENTS

(please continue on a separate sheet if necessary)

Name of Referee ……………………………………………………………………………… Signature ………………………………………………………………………………………

Position held ………………………………………………………………………………………………………………………………………. Date ……………………………………………

Institution/Company
Name and Address …………………………………………………………………………………………………………………………………………………………………………………………

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