International Postgraduate Scholarship Application Form

APPLICATION FOR INTERNATIONAL POSTGRADUATE SCHOLARSHIP 2010/2011 Ten Goldsmiths International Postgraduate Scholarships are available to students studying for a taught Masters’ degree at Goldsmiths. The scholarship provides a fee waiver of £5,000. Deadline to apply is 1 April 2010. INSTRUCTIONS: • Ensure your application and supporting documents are TYPED if possible. If you are unable to type the form, please make sure you write legibly (print in black ink). • You must include an EMAIL ADDRESS on the form. • Your reference(s) must be signed, dated and printed on letter-headed paper. • Provide COPIES of transcripts and certificates, not originals. • You must have applied for a place on your chosen course before 1 April 2010. • If you would like this form to be sent to you in an alternative format, please contact us. SECTION A – PERSONAL DETAILS Surname/Family Name:       First Name/s:       Title:       Date of Birth (dd/mm/yyyy):       Nationality:       CONTACT Email Address:       Telephone (include country code):       CORRESPONDENCE ADDRESS Street Address: City and Region /County/ Province/ State: Postcode: Country:

                       

INTENDED PROGRAMME OF STUDY AT GOLDSMITHS Qualification Sought (e.g. MA):       Programme/Course Title:       Goldsmiths Department:       Mode of study (FT or PT)       Type of offer held (if you hold one e.g. unconditional or       conditional): Programme Start Date:       Fee Status       (UK/EU/International): Student ID number (if known):       SECTION B – ACADEMIC AND WORK HISTORY 1

EDUCATION FROM THE AGE OF 17 Start with current or most recent, and include professional qualifications where appropriate Institution Start End Qualificati Subjec Overal Possible grade Name & date Date on t l range Location (city (mm/yyy (mm/yyy achieved Grade, (highest – lowest and country) y) y) (e.g. A GPA e.g. 1-6, A-F, 100% Levels, IB, or 0%) Abitur, BA, Class BSc, MA…..)                                                                                                                                                                                                                                                                                                                                                 EMPLOYMENT, TRAINING AND WORK EXPERIENCE Where relevant to the programme or scholarship requirements Employer name and location Start Date End Date (city and country) (mm/yyyy) (mm/yyyy)                                                                        

Position held                        

Languag e at work                        

PRIZES, AWARDS AND SCHOLARSHIPS AWARDED FOR PREVIOUS STUDY/RESEARCH We may request proof of the information you give below. Name of Prize, Award or Purpose Overall value Date awarded Scholarship What was the prize, GB£ (mm/yyyy) or Please list only those awarded on award or scholarship if applicable Duration the basis of academic awarded for? as applicable merit/achievement                                                                                                

SECTION C – SUPPORTING DOCUMENTS 2

You MUST attach the documents listed below, regardless of which scholarship you have applied for. Without them your application will be deemed invalid. Please indicate in the right-hand column which documents you have enclosed. Photocopies of official college and university degree certificates and transcripts Academic Reference relating to your current or most recently completed course (e.g. from personal tutor) Personal statement explaining why you feel you are a deserving candidate for this scholarship (one A4 page max – Arial 11 pt)

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SECTION D – APPLICANT’S DECLARATION Please read the following statements and sign below to indicate acceptance of these terms:  I declare that the information I have provided on this form is correct to the best of my knowledge  I consent to my data being processed and shared with college staff for the purposes of selection, assessment, payment, reporting and monitoring  I understand that if, subsequent to submitting my application, information I have supplied in support of my application is found to be incorrect, Goldsmiths College reserves the right to reject the application  I understand that the personal data which I have provided on this form may be stored in paper and/or electronic form in accordance with Goldsmiths College policies on Data Protection (available at: http://www.gold.ac.uk/data-protection/) and with the provisions of the Data Protection Act (1998)

Signature:

Date:

EMAIL APPLICATIONS: If you are emailing your application to us (along with scanned documents) please tick this box to indicate your acceptance of the above terms:

Please return this form to: Bursaries & Scholarships Officer, Student Support RHB 124, Goldsmiths, University of London, New Cross, London SE14 6NW or by email to [email protected]

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