Serial number

THE LEEDS MBA – APPLICATION FOR ADMISSION

A. PERSONAL DETAILS (please complete using block capitals throughout)

Title Family Name (Surname): Date of Birth

Day Month Year

Given Names (First name): Previous Names(s), if changed Sex

M F

Permanent Home Address Correspondence Address (with dates)

Tel. No. Tel. No.

Fax: Fax:

Email: Email:

Country of Birth: Nationality:

Residential code (see Notes for Guidance)

B. TAUGHT DEGREE PROGRAMME SOUGHT

Full-time MBA; Executive MBA;

(FOR OFFICE USE ONLY) DEPARTMENTAL RECOMMENDATION

Dept / School / Inst F/T or P/T Major Course Code

Qualification and Programme Title Banner Programme Code

Conditions

Accept Starting Date Period of study Calendar year(s) Reject

(enter number in box) Academic year(s)
Semesters
Months
Signature and Date
C. PREVIOUS HIGHER EDUCATION AND PROFESSIONAL QUALIFICATIONS (see Notes for Guidance)

University/Institution Dates Qualification obtained Subject Language of Class/Result Date

Instruction obtained
Start Finish

Examinations still to be taken: (include date of completion)

D. ENGLISH LANGUAGE QUALIFICATIONS (see Notes for Guidance)

Is English your first/native language? Yes No

Was English the language of instruction for your first degree? Yes No

If English is not your first/native language you will be required to demonstrate competence through IELTS, TOEFL or the
Cambridge Certificate.

Most recent test results:

IELTS: Listening: Reading: Writing: Speaking: Overall Band:

TOEFL: Total Score: TWE (Test of Written English) or Essay Writing score:

Cambridge Certificate: Grade:

E. GMAT (see Notes for Guidance)

Have you taken a GMAT (Graduate Management Admission Test)? Yes No

If YES, please state your total score and date of test: ….............................................................................................

F. EMPLOYMENT HISTORY (see Notes for Guidance)

Name and Address of Employer Job Title Dates

Present first From (month/year): To (month/year):
For your present or most recent position please supply the following information:

Industry Sector:

Advertising, PR & Marketing Aerospace Agriculture Arts, Music & Film

Automobiles & Parts Biotechnology Chemicals Complementary Medicine
Conglomerates Construction/Building Mgmt Consulting Consumer Products/Durables
Education/Academic Research Electronics/Electrical Eng Energy & Utilities Financial Services (Retail)
FMCG Food Production Heavy Industry/Manufacturing Hospitality & Leisure
Industrial Products Information Technology Insurance Internet & E-Business
Investment Banking & Trading Manufacturing (other) Mechanical Engineering Non Profit NGOs
Oil & Gas Own Business Packaging Pharmaceuticals & Healthcare
Printing/Publishing/Media Professional Services Property & Property Management Public Sector & Government
Recruitment & Training Retailing Sport & Leisure Telecommunication
Textiles Timber & Paper Transport & Logistics Travel
Wholesale Trading Other (please specify):

Number of employees: Under 10 11-249 250-499 500-999 Over 1000

Employer’s web address:

Functional Role:

Accounting Administration Arts & Music Management Commercial Planning & Analysis
Consultancy Corporate Finance & Trading Financial Control & Planning General Management
Healthcare Professional HRM IT & Systems Management Legal
Marketing & Advertising Product Development Production & Operations Mgmt Project Management
Research & Development Sales & Business Development Strategy & Corporate Planning Student
Teaching/academic Research Other (please specify):

Current or most recent annual salary (converted to UK £s):

Managerial responsibility (please state the number of staff and size of budget for which you are
directly responsible):

Please provide a description of your present or most recent position:

G. COMPETENCY PROFILING

Please answer the following questions on a separate sheet of paper, with your name at the top of each page. Please enclose
answers with your application form. Your answer to each question should not exceed 400 words.

Question 1.

Describe a situation at work which required you to work with others to achieve results. Describe what role you played, how you
overcame difficulties and what you learned from the experience.

Question 2.

Describe a work situation where you had to prepare a business proposal or case. How did you do this, and would you do things
differently with hindsight?

Question 3.

Describe your motivation for doing an MBA, in particular how you see it helping your career development.

H. REFEREES
Please read Notes for Guidance carefully. You should enclose two reference forms with your application. You should provide
one academic and one employer reference. If you have been out of full-time education for five years or more, then two employer
references will suffice.

Name Name

Occupation Occupation

Address Address

Tel No: Tel No:

Fax: Fax:

Email: Email:

H. ADDITIONAL PERSONAL DETAILS

Name and Address of next of kin.

Relationship of next of kin to you.

I. IMPAIRMENT/DISABILITY: if you have entered any number between 1 and 9 on the Equal Opportunities Monitoring
form, please indicate any additional support you may require.
J. FINANCE Who will be paying your fees and providing funds for living expenses? (Please tick appropriate boxes)

Self: You will be required to satisfy the University that you have sufficient funds.

Sponsor: Have you already secured sponsorship for your studies? Yes No

If you have arranged sponsorship, give the name and address of your sponsor below and enclose a copy of your letter of
confirmation of funding. If no award has been made, give details of the sponsors you are approaching.

Academic fees: details of sponsorship

Living expenses: details of sponsorship

Any criminal conviction? (See Notes for Guidance). If a serving prisoner, please supply the prison address in the box below.

Yes No

I confirm that the information I have given is correct to the best of my knowledge. Applicants are advised that information given
which is later found to be false may lead to withdrawal of any offer of a place at the University.

The University will use this information for the purpose of admission and to form part of a subsequent student record. We may
use this information to collect statistics but will not publish any information that may identify you. I give my consent to the
processing of my data as outlined above.

Signature Date

Day Month Year

Please send your completed application form with references, transcripts, IELTS / TOEFL / Cambridge Certificate scores (if
applicable) and any letters of sponsorship to:

MBA Admissions
Leeds University Business School
Maurice Keyworth Building
University of Leeds
Leeds, LS2 9JT
United Kingdom
K. OTHER INSTITUTIONS
To which other institutions have you applied?

L. CONTACT WITH THE UNIVERSITY OF LEEDS

How did you learn about postgraduate study opportunities at Leeds?

Have you applied to Leeds previously? To Which Department? When? (Date)

THE LEEDS MBA®
CONFIDENTIAL REFERENCE (see Notes for Guidance)

To be completed by the applicant:

Surname / Family name:………………………………………………………………………………………..

Given names (First name):……………………………………………………………………………………...

Programme of study:……………………………………………………………………………………………

Month and year of commencement:……………………………………………………………………………

To be completed by the referee (see Notes for Guidance):

The above named individual is applying for admission to the Leeds MBA programme and has provided your
details as a referee. We would be grateful if you would complete this reference form and return it direct to
MBA Admissions, Leeds University Business School, Maurice Keyworth Building, University of Leeds,
Leeds LS2 9JT, UK. The information you provide will be treated in the strictest confidence.

Please assess the applicant’s competencies against a peer group at a similar stage in their career.

Description of peer group (e.g. level of management, country, student cohort):

Above Average
Below Average

High Achiever

Judge/Don’t
Exceptional
Achiever
Average

Know
Can’t
Drive
Taking responsibility
Ability to work with others
Leadership (potential)
Creative thinking
Planning & organising (including self)
Emotional resilience
Self-awareness
Analytical thinking
Judgement
Breadth of interest
Interpersonal skills
Integrity
Self-confidence

Written communication skills (English)

Oral communication skills (English)
Confidence with numbers (quantitative skills)
Intellectual ability to complete a Master’s degree
Please use the space below to provide a short statement on the candidate’s suitability for The Leeds MBA,
and any further supporting comments you wish to make (see Notes for Guidance).

For further information about The Leeds MBA and Leeds University Business School, please visit our
website at: www.leeds.ac.uk/lubs

Signature of referee:

Name and position:

Address:

Telephone:

Email:
REFEREES – NOTES FOR GUIDANCE

Important Information for Applicants

You should enclose two reference forms with your application. You should provide one academic and one
employer reference. If you have been out of full-time education for five years or more, then two employer
references will suffice.

Academic References
i. References should be from people not related to you by blood or marriage.
ii. Your referees should be qualified to comment on your academic ability, if possible at the highest
academic level in which you have studied.
iii. Academic references must be submitted using the form provided.
iv. You should include both reference forms with your application in a sealed envelope which has been
signed across the seal with a college or official stamp. If you are not able to enclose transcripts and
references with your application form, please send them directly to: MBA Admissions, Leeds
University Business School, Maurice Keyworth Building, University of Leeds, Leeds, LS2 9JT, UK.

Employer References
i. References should be from people not related to you by blood or marriage.
ii. Your referees should be qualified to comment on your work performance and behaviours and should
ideally come from your present or most recent employer (it is appreciated that it may not be possible
to arrange this at the point at which you apply for the Leeds MBA).
iii. References must be submitted on the form provided and must be signed.
iv. You should include both references with your application in a sealed envelope which has been
signed across the seal with a college or official stamp. If you are not able to enclose transcripts and
references with your application form, please send them directly to: MBA Admissions, Leeds
University Business School, Maurice Keyworth Building, University of Leeds, Leeds, LS2 9JT, UK.

Important Information for Referees

References must be submitted using the enclosed form and must be signed. Please include the name of the
applicant and the programme applied for. Please also include your name, position/status, address, telephone
number, fax and / or email address. The completed reference should be placed in a sealed envelope which
has been signed across the seal with a college or official stamp. Please use the following guidelines when
considering the candidate’s suitability for the Leeds MBA.

Academic Referees
i. Please state how long and in what capacity you have known the applicant.
ii. What do you consider to be his/her main strengths?
iii. Please include detailed information on results obtained by the applicant and prediction of likely
degree result if the applicant has not yet graduated.
iv. Your assessment of the suitability of the applicant for the Leeds MBA programme.
v. Please comment on his/her English language proficiency – ability to speak, write and comprehend
English, if the applicant’s native language is not English.

Employer Referees
i. Please state how long and in what capacity you have known the applicant.
ii. What do you consider to be his/her main strengths in the areas of a) initiative, b)diligence,
c)flexibility, d)group working, e)critical/analytical abilities?
iii. Your assessment of the suitability of the applicant for an intensive management education degree.
THE LEEDS MBA®
CONFIDENTIAL REFERENCE (see Notes for Guidance)

To be completed by the applicant:

Surname / Family name:………………………………………………………………………………………..

Given names (First name):……………………………………………………………………………………...

Programme of study:……………………………………………………………………………………………

Month and year of commencement:……………………………………………………………………………

To be completed by the referee (see Notes for Guidance):

The above named individual is applying for admission to the Leeds MBA programme and has provided your
details as a referee. We would be grateful if you would complete this reference form and return it direct to
MBA Admissions, Leeds University Business School, Maurice Keyworth Building, University of Leeds,
Leeds LS2 9JT, UK. The information you provide will be treated in the strictest confidence.

Please assess the applicant’s competencies against a peer group at a similar stage in their career.

Description of peer group (e.g. level of management, country, student cohort):

Above Average
Below Average

High Achiever

Judge/Don’t
Exceptional
Achiever
Average

Know
Can’t
Drive
Taking responsibility
Ability to work with others
Leadership (potential)
Creative thinking
Planning & organising (including self)
Emotional resilience
Self-awareness
Analytical thinking
Judgement
Breadth of interest
Interpersonal skills
Integrity
Self-confidence

Written communication skills (English)

Oral communication skills (English)
Confidence with numbers (quantitative skills)
Intellectual ability to complete a Master’s degree
Please use the space below to provide a short statement on the candidate’s suitability for The Leeds MBA,
and any further supporting comments you wish to make (see Notes for Guidance).

For further information about The Leeds MBA and Leeds University Business School, please visit our
website at: www.leeds.ac.uk/lubs

Signature of referee:

Name and position:

Address:

Telephone:

Email:
REFEREES – NOTES FOR GUIDANCE

Important Information for Applicants

You should enclose two reference forms with your application. You should provide one academic and one
employer reference. If you have been out of full-time education for five years or more, then two employer
references will suffice.

Academic References
i. References should be from people not related to you by blood or marriage.
ii. Your referees should be qualified to comment on your academic ability, if possible at the highest
academic level in which you have studied.
iii. Academic references must be submitted using the form provided.
iv. You should include both reference forms with your application in a sealed envelope which has been
signed across the seal with a college or official stamp. If you are not able to enclose transcripts and
references with your application form, please send them directly to: MBA Admissions, Leeds
University Business School, Maurice Keyworth Building, University of Leeds, Leeds, LS2 9JT, UK.

Employer References
i. References should be from people not related to you by blood or marriage.
ii. Your referees should be qualified to comment on your work performance and behaviours and should
ideally come from your present or most recent employer (it is appreciated that it may not be possible
to arrange this at the point at which you apply for the Leeds MBA).
iii. References must be submitted on the form provided and must be signed.
iv. You should include both references with your application in a sealed envelope which has been
signed across the seal with a college or official stamp. If you are not able to enclose transcripts and
references with your application form, please send them directly to: MBA Admissions, Leeds
University Business School, Maurice Keyworth Building, University of Leeds, Leeds, LS2 9JT, UK.

Important Information for Referees

References must be submitted using the enclosed form and must be signed. Please include the name of the
applicant and the programme applied for. Please also include your name, position/status, address, telephone
number, fax and / or email address. The completed reference should be placed in a sealed envelope which
has been signed across the seal with a college or official stamp. Please use the following guidelines when
considering the candidate’s suitability for the Leeds MBA.

Academic Referees
i. Please state how long and in what capacity you have known the applicant.
ii. What do you consider to be his/her main strengths?
iii. Please include detailed information on results obtained by the applicant and prediction of likely
degree result if the applicant has not yet graduated.
iv. Your assessment of the suitability of the applicant for the Leeds MBA programme.
v. Please comment on his/her English language proficiency – ability to speak, write and comprehend
English, if the applicant’s native language is not English.

Employer Referees
i. Please state how long and in what capacity you have known the applicant.
ii. What do you consider to be his/her main strengths in the areas of a) initiative, b)diligence,
c)flexibility, d)group working, e)critical/analytical abilities?
iii. Your assessment of the suitability of the applicant for an intensive management education degree.
THE LEEDS MBA®
Notes for Guidance: Application for the Leeds MBA

GENERAL
Please either type this form or complete it in black ink using block capitals throughout. Complete all
sections of the application as fully as possible. If the section does not apply to you, please indicate this with
N/A. Do not refer to attachments e.g. C.V. or résumé. Provided that you complete all sections of the form,
you may supply additional detail (on A4 paper).

A. PERSONAL DETAILS
Please include your family name (surname) and given names (first names) as they are written in your
passport or birth certificate. Do not use informal or nicknames on your application. Refer to any previous
names in order to confirm that certificates and transcripts using a previous name are yours.

B. MBA PROGRAMME SOUGHT

Please specify which Leeds MBA programme you wish to apply for (Full-time or Executive).

C. HIGHER EDUCATION TO DATE AND PROFESSIONAL QUALIFICATIONS

Please include transcripts of your results (including explanation of marking systems) with your application.
If these are in a language other than English, please include official translations. Please quote the title used
on the degree certificate/transcript and indicate the system used, i.e. grades, grade point average, percentage.
If your final result is not known at the time of application, please indicate when your results will be known
and send these to MBA Admissions, Leeds University Business School, Maurice Keyworth Building,
University of Leeds, Leeds LS2 9JT, UK, as soon as they become available.

In exceptional circumstances the normal academic entry qualifications of at least an upper second-class
degree may be waived for applicants with professional qualifications and/or extensive executive work
experience. If you wish to apply for admission to the Leeds MBA programme (Full-time or Executive) but
are without higher education qualifications, please enclose with your application a statement of your
professional qualifications and your executive work experience. Please ensure that you include your name
and details at the top of your additional statement.

D. ENGLISH LANGUAGE QUALIFICATIONS

Please include copies of results of any formal tests you have completed, e.g. IELTS, TOEFL or Cambridge
Certificate. For applicants whose first language is not English, the University’s minimum English language
requirement is a TOEFL score (paper-based test) of at least 580 with 4.0 on the Test of Written English –
TWE or 240 with 4.0 on essay writing (computer-based test); or a minimum IELTS score or 6.5 with not
less than 6.0 in all sections, or a Cambridge Certificate grade of at least ‘C’.

E. GMAT
Please enclose a copy of your score report with your application. Although GMAT is not a condition for
entry to the Leeds MBA, provision of your score report will assist the Programme Director when
considering your application.

F. EMPLOYMENT HISTORY
Please present a list of job titles and employers, with dates, starting with your present or most recent job.
Provide details for the last ten years or since you started working full-time.

For your present or most recent employment, please indicate the sector and the total number of employees
for the whole corporate entity. Please also supply the web page reference if available.

For your present or most recent employment, indicate your functional role (e.g. marketing, finance,
operations); your salary converted to UK £ at the current rate of conversion rounded to the nearest whole
thousand; managerial responsibility including the number of staff and size of budget which you are directly
responsible for managing.

H. REFEREES

You should enclose two reference forms with your application. You should provide one academic and one
employer reference. If you have been out of full-time education for five years or more, then two employer
references will suffice.

Academic References
i. References should be from people not related to you by blood or marriage.
ii. Your referees should be qualified to comment on your academic ability, if possible at the highest
academic level in which you have studied.
iii. Academic references must be submitted using the form provided.
iv. You should include both reference forms with your application in a sealed envelope which has been
signed across the seal with a college or official stamp. If you are not able to enclose transcripts and
references with your application form, please send them directly to: MBA Admissions, Leeds
University Business School, Maurice Keyworth Building, University of Leeds, Leeds, LS2 9JT, UK.

Employer References
i. References should be from people not related to you by blood or marriage.
ii. Your referees should be qualified to comment on your work performance and behaviours and should
ideally come from your present or most recent employer (it is appreciated that it may not be possible
to arrange this at the point at which you apply for the Leeds MBA).
iii. References must be submitted on the form provided and must be signed.
iv. You should include both references with your application in a sealed envelope which has been
signed across the seal with a college or official stamp. If you are not able to enclose transcripts and
references with your application form, please send them directly to: MBA Admissions, Leeds
University Business School, Maurice Keyworth Building, University of Leeds, Leeds, LS2 9JT, UK.

Important Information for Referees

References must be submitted using the enclosed form and must be signed. Please include the name of the
applicant and the programme applied for. Please also include your name, position/status, address, telephone
number, fax and / or email address. The completed reference should be placed in a sealed envelope which
has been signed across the seal with a college or official stamp. Please use the following guidelines when
considering the candidate’s suitability for the Leeds MBA.

Academic Referees
i. Please state how long and in what capacity you have known the applicant.
ii. What do you consider to be his/her main strengths?
iii. Please include detailed information on results obtained by the applicant and prediction of likely
degree result if the applicant has not yet graduated.
iv. Your assessment of the suitability of the applicant for the Leeds MBA programme.
v. Please comment on his/her English language proficiency – ability to speak, write and comprehend
English, if the applicant’s native language is not English.

Employer Referees
i. Please state how long and in what capacity you have known the applicant.
ii. What do you consider to be his/her main strengths in the areas of a) initiative, b)diligence,
c)flexibility, d)group working, e)critical/analytical abilities?
Your assessment of the suitability of the applicant for an intensive management education degree.
J. FINANCE
UK/EU applicants who wish to be considered for a Research Council or other Government financed
studentship for which application is made by the Department accepting the student (e.g. EPSRC quota
scholarship) should indicate this clearly in the sections headed ‘Academic fees’ and ‘Living expenses’ as
appropriate. If you are applying for University or Departmental scholarships or bursaries, you must apply
on the appropriate form in addition to this application. The results of scholarship applications are notified
separately from the application for a place on a programme.

L. CONTACT WITH THE UNIVERSITY

This section is to help the University monitor the effectiveness of its marketing.

Scholarships

All requests for information regarding scholarships should be directed to:

Research Degrees and Scholarships Office
University of Leeds, Leeds LS2 9JT.

Phone numbers:
UK Students: 0113 343 4077
International Students: +44-113 343 4007
Email: [email protected]
Web page: www.leeds.ac.uk/students/scho.htm

Residential code (fee status)

The University is required to make a decision about your fee status. To help us do this, please choose a
category from the list below. Most UK/EU applicants will be category A. The code you choose is
provisional. The University will make the final decision using DFES (Department of Education and Skills)
and UKOSA (Council for International Education) guidelines. If there is any doubt regarding your fee
status, the University will ask you to complete an assessment form.

A You are a UK/EU1 national, live in the Channel Islands or Isle of Man or are the child of a UK/EU1
national, and have lived in the EEA for three years – but not just for full-time education.

B You have settled (lived) in the UK for three years, but not just for full-time education.

C You are a refugee, or have been granted Exceptional leave to Enter or Remain in the UK, and you have
lived in the UK since status was recognized or granted, or you are such a person’s husband, wife or child.

D You are a national of Iceland, Liechtenstein or Norway, you have lived in the UK and are a migrant
worker (or you are such a person’s husband, wife or child), or you live in the EEA but not just for full-time
education.

G You are a UK/EU1 national, or a child of a UK/EU1 national, and normally live in the EEA2 but
temporarily work outside the EEA2.

O Other

Note
1. The above reference to the European Union includes the following countries: Austria; Belgium; Cyprus;
Czech Republic; Denmark (excluding the Faroe Islands and Greenland); Estonia; Finland; France;
Germany; Greece; Hungary; Republic of Ireland; Italy; Latvia; Lithuania; Luxembourg; Malta; Portugal;
Slovakia; Slovenia; The Netherlands; Portugal; Spain; Sweden; The United Kingdom.

2. The above references to the EEA include all countries in the EU plus Iceland, Liechtenstein and Norway.
Criminal Convictions
If you have been convicted of a criminal offence, excluding a) a motoring offence for which a fine and/or a
maximum of three penalty points were imposed or b) spent sentences, you are required to declare this by
completing the ‘yes’ box in the criminal conviction section of the application form. Serving prisoners
should also supply the prison address so that a reference may be sought. The University will send a
questionnaire for completion to all successful applicants declaring a criminal conviction. The information
submitted in the questionnaire will be treated in the strictest confidence.
Equal Opportunities Monitoring Form

The following information is for Central Student Administration purposes and will not form part of the
academic decision-making process on your application.

Please complete the following and detach it along the perforated lines and place in a sealed envelope
marked E.O. Monitoring Form with surname and initials.

Impairment / Disability

If you have a disability or medical condition that may require extra support or specific facilities to aid your
study, please tick the code that is most applicable to you. You may, if you wish, give further detail in
Section I of the application form.

1. Dyslexia
2. Blind / Partially sighted
3. Deaf / Hearing impairment
4. Wheelchair user / Mobility difficulties
5. Autistic or Asperger syndrome
6. Mental health difficulties
7. Unseen disabilities e.g. Diabetes, epilepsy
8. Multiple disabilities
9. Disability not listed

If you have any queries regarding support arrangements or visits to the University, you should
contact the Equality Unit, University of Leeds, Leeds, LS2 9JT; Tel 0113 343 3927.

Ethnicity Details (UK nationals only)

White Black, Black British, Black English,

Black Scottish or Black Welsh
English 11 Caribbean 21
Irish 12 African 22
Scottish 13 Other black background 29
Welsh 15
Other white background 18
Chinese, Chinese British, Chinese
English, Chinese Scottish or Chinese
Welsh
Chinese 34
Asian or Asian British, Asian
English, Asian Scottish, Asian
Welsh
Indian 31 Mixed
Pakistani 32 White and Black Caribbean 41
Bangladeshi 33 White and Black African 42
Other Asian background 39 White and Asian 43
Other mixed background 49
Other ethnic background 80

For CSA use: