For Office Use RDB1

Date Received

App ID

Outcome
ROEHAMPTON UNIVERSITY

INITIAL APPLICATION FOR A HIGHER DEGREE BY RESEARCH

SECTION 1: PROGRAMME DETAILS

Please type this form or complete it legibly in black ink. Please return the form, with attachments, to the Graduate School,
Roehampton University,Richardson Building, Digby Stuart College, Roehampton Lane, London, SW15 5PH. Please do
not staple your application, as it will be photocopied.
An electronic copy of this form is available to download from the University’s website:
http://www.roehampton.ac.uk/graduateschool/prospectiveresearchstudents/howtoapply/index.html

Which Department are you applying to?

Department of Social Sciences Department of Media, Culture & Language
Department of Life Sciences Department of English & Creative Writing
Department of Psychology Department of Drama, Theatre & Performance
Department of Education Department of Dance
Department of Humanities Roehampton University Business School

Which Research Centre(s) are you applying to?

(For a list of Research Centres see the accompanying
guidance notes)

Which programme are you applying for?

MPhil MPhil/PhD PsychD Forensic Psychology

What is your proposed mode of study?

Part-time Full-time

What is your proposed start date?

(1st October, 1st January or 1st April)

SECTION 2: PERSONAL DETAILS

Title First name(s) Surname

Preferred name (if different to the

above)
Previous Surname (if applicable)
Date of Birth
Nationality
Country of Permanent Residence
Years Resident in Above Country

E-mail Address
Daytime Telephone Number
Evening Telephone Number
Mobile Number

Permanent Home Address Address for Correspondence (if different)

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SECTION 3: FUNDING

Are you in receipt of any sponsorship or scholarship? Yes No

If yes:
i. will your sponsorship or scholarship cover your tuition fees? Yes No

ii please specify any conditions attached to your sponsorship or scholarship

Please give details here if you intend to apply, or have already applied, for funding towards your research degree:

If your tuition fees are not covered by sponsorship or a scholarship, how will you fund your intended programme of study?

SECTION 4: ACADEMIC QUALIFICATIONS

Please give details of all tertiary level qualifications (for example, Certificate/Diploma in Higher Education, First Degree,
Higher Degree). Please note that you must attach your academic transcripts.

Institution Dates Attended Subject Level of Award Date of Award

SECTION 5: PROFESSIONAL QUALIFICATIONS

Please give details of any professional qualifications or other relevant qualifications not listed in section 4 above

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SECTION 6: PROFICIENCY IN ENGLISH

If English is not your first language, nor the language in which you received your education, please give details of any
English Language courses taken or about to be taken, and attach, if possible, a certificate of proficiency showing ability to
speak, write and understand English. Please note that University Regulations require research students to meet a
minimum level of English Language proficiency, which is currently IELTS 7.0 in all bands (or the equivalent score on
another English Language exam).

Have you achieved an IELTS score of 7.0 or equivalent in all bands? Yes No

SECTION 7: OCCUPATIONS

Please give details of past and present occupations with dates (in chronological order)

Employer Dates Employed Job Title Brief Description of Main Duties

SECTION 8: RELEVANT EXPERIENCE

Please give details of any experience or other information (e.g., publications, research experience) relevant to your
application. You should include details of any research methods training you have already completed. Please continue on
a separate sheet if necessary.

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SECTION 9: ACADEMIC REFEREES
Please give details (including name, postal address, e-mail address and a contact telephone number) of two academic
referees who will support your application. Please note that your academic referees cannot be the same people as those
likely to supervise your research. It is preferable for you to provide letters from your referees (in signed and sealed
envelopes) at the time of application. Referees’ letters should include how they are acquainted with you, their experience
with/opinion of your academic work and your suitability for undertaking a research degree.

Name and Relationship to You Address Telephone Number & E-mail Address

SECTION 10: TITLE OF RESEARCH PROPOSAL

Please give the proposed title of your research project

If you have already been in discussion with a member of academic staff regarding your proposal, please enter his/her name
below:

SECTION 11: RESEARCH PROPOSAL

You should discuss your research proposal with the contact person listed in the application pack before completing this
section.

Part A: The Scope of the Proposed Research

Please give an outline of your proposed programme of research. Parts A,B and C should each be 300-500 words long
(please continue on a separate sheet if necessary). Assessors may request further details about your research proposal
prior to interview if necessary. You should try to include:

i. a non-technical summary of your proposed research

ii. a description of the broad subject area of your project, including its relation to other work in the field
iii. the aims and objectives of your proposed research
iv. an outline of any hypotheses or research questions which will be addressed
v. a brief, indicative bibliography

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Part B: Research Methodology and Design

Please give a brief indication of the proposed design of the project, including the research methodology to be used.
You should try to include:

i. an indication of the proposed methods to be used in the research (including the gathering and analysing and/or
interpretation of data/information)
ii. the reasons for selecting these methods given the subject area described in Part A above
iii. a provisional timetable of the work through to the submission of the completed thesis, including, if relevant, the
dates and expected length of any fieldwork to be undertaken abroad

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Part C: Training, Facilities and Resources

Please indicate any specialist training, including taught research methods programmes, and other resources necessary
for the research (e.g., laboratory space, computing facilities, specialist Library access). Please note that students in the
School of Education and the School of Business & Social Sciences may be required to complete the University’s
Postgraduate Diploma in Social Research Methods as part of their research programme.

SECTION 12: SIGNATURE OF APPLICANT

a) I certify that the statements made by me on this form are correct

b) I understand that in signing below I agree to Roehampton University processing my personal data (as defined by the
Data Protection Act 1998), for administrative purposes as notified to the Office of the Information Commissioner.
c) If I am applying to the Department of Education or the Department of Social Sciences or the Roehampton Business
School, I understand that I will be required to complete the University’s Postgraduate Diploma in Social Research
Methods as part of my research programme.

Signature: Date:

You should send your application to the Graduate School Officer using the address at the top of this
form. Applicants are advised to send their applications by registered post or courier to ensure
delivery. Applicants who wish to receive acknowledgement of receipt should include a stamped self-
addressed postcard with their application. Postcards without the correct postage will not be
returned. Please do not staple any parts of your application form (or associated documents) as these
will be photocopied.

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