Graduate Studies Prospectus 2010–2011

Application Pack
NOTES
 Board of Graduate Studies

HOW TO APPLY PAGE 1 OF 5

HOW TO APPLY PAGE 2 OF 5
HOW TO APPLY PAGE 3 OF 5
HOW TO APPLY PAGE 4 OF 5
HOW TO APPLY PAGE 5 OF 5
NOTES
APPLICATION FORM INSTRUCTIONS PAGE 1 OF 4
APPLICATION FORM INSTRUCTIONS PAGE 2 OF 4
APPLICATION FORM INSTRUCTIONS PAGE 3 OF 4
APPLICATION FORM INSTRUCTIONS PAGE 4 OF 4
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!

"#$%&$'(!)%*+,,+-.!$.%!
/01-2$#,1+3!)332+0$'+-.!4-#*! !

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Board of Graduate Studies
!

! !
Type of application!532($,(!'+0A!-.(!>-9!>(2-B8!
!
! ADMISSION! CONTINUATION! RE-ADMISSION!
4+9!:-&#!31-'-;#$31!
C!B+,1!'-!$332:!?-#!admission!! C!$*!0&##(.'2:!$!graduate!,'&%(.'!$'!! C!B$,!3#(E+-&,2:!$!graduate!,'&%(.'!!
1(#(<!=1(!31-'-!
$,!$!;#$%&$'(!,'&%(.'!$'!'1(! '1(!D.+E(#,+':!-?!F$*>#+%;(!$.%!B+,1! $.%!B+,1!'-!$332:!?-#!re-admission!!
*&,'!>(!.-!2$#;(#! D.+E(#,+':!-?!F$*>#+%;(<! '-!continue!-.!$.-'1(#!0-&#,(<! '-!$.-'1(#!0-&#,(<!
'1$.!'1+,!>-9!$.%!!
! Please see http://www.admin.cam.ac.uk/offices/gradstud/current/continuing!
-?!1+;1!@&$2+':<! ! !

! G$E(!:-&!3#(E+-&,2:!$332+(%!'-!'1(!D.+E(#,+':!-?!F$*>#+%;(!?-#!;#$%&$'(!$%*+,,+-.,!-#!,'&%+(%!$'!'1(!D.+E(#,+':!-?! !
! F$*>#+%;(!$,!$.!&.%(#;#$%&$'(!-#!;#$%&$'(!,'&%(.'H!
7-!:-&!B+,1!'-!>(!0-.,+%(#(%!?-#!AHRC or other Research Council fundingH!5IG-*(J!$.%!IKDJ!?((!,'$'&,!,'&%(.',!-.2:8! !
!

SECTION A: To be completed by all applicants

!

A(1) Personal details!

If you had a different name during any previous
Name (as on passport) Name (previous)!! study at Cambridge, please include it here.
L$,'!5?$*+2:8! ! ! L$,'!5?$*+2:8! !
4+#,'! ! ! 4+#,'! !
M'1(#!.$*(,! ! ! M'1(#!?+#,'!.$*(,! !
=+'2(!5N#ON#,ON+,,O7#!('08! ! ! =+'2(!5N#ON#,ON+,,O7#!('08! !

Date of Birth Nationality and residence !

! ! !

! ! ! !
F-&.'#:!-?!3(#*$.(.'!#(,+%(.0(! ! 7-!:-&!#(@&+#(!$!E+,$!! !P(,!
77! NN! PPPP! '-!(.'(#!'1(!DRH! !Q-!
Q$'+-.$2+':! !
Sex S$,,3-#'!Q&*>(#T! !
).:!,(0-.%!.$'+-.$2+':! !
! !
!!N$2(! ! !4(*$2(! F-&.'#:!-?!>+#'1!
! ! !
!

A(2) Contact Information!

! Mailing Address !! Home (permanent) Address (if different)

Q&*>(#O,'#(('! ! !
! ! !
=-B.!-#!0+':! ! !
F-&.':O3#-E+.0(O,'$'(! ! !
S-,'$2!0-%(! ! !! !
F-&.'#:! ! !
=(2(31-.(!52$.%2+.(8! ! !

=1+,!$%%#(,,!+,!E$2+%!&.'+2T! C!1$E(!2+E(%!$'!'1+,!$%%#(,,!,+.0(T!
!
! ! ! 77ONNOPPPP! ! ! ! 77ONNOPPPP!
! !
!
N->+2(!S1-.(!
Please write very clearly, we will use your email to
K*$+2!)%%#(,,! communicate with you during the application process.
!
!

A(3) Programme of Study!

Date you wish to start 5'+0A!-.(!-.2:8! Study mode 5'+0A!-.(!-.2:8 S2($,(!.-'(T!+'!+,!;(.(#$22:!.-'!3-,,+>2(!'-!

->'$+.!$!,'&%(.'!E+,$!'-!,'&%:!3$#'Z'+*([!
not all courses are available part-time Z!
!U!M0'!VWUW! X!Y$.!VWUU! UW!)3#!VWUU! !!4&22Z=+*(! !!S$#'Z=+*(!
! ! ! see Prospectus.

Details of your programme of study. F-.,&2'!'1(!$33#-3#+$'(!(.'#:!+.!'1(!"#$%&$'(!/'&%+(,!S#-,3(0'&,!>(?-#(!0-*32('+.;!'1(!?+(2%,!+.!'1+,!,(0'+-.<!

!

Course code Programme of study or research area Department Final Award Duration

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A(4) College membership (Please consult the ‘College Selection Criteria’ section in the Prospectus; Continuing Students see below)!

You may choose up to two Cambridge Colleges to consider your application<!If you do not indicate a choice in this section, the Board
of Graduate Studies will allocate a College for you. You cannot amend these choices after you have submitted your application.!
!

C.!'1(!F-22(;(!F1-+0(!4-#*!>(2-B\!B#+'(!]U]!+.!'1(!>-9!.(9'!'-!:-&#!U,'!01-+0(!F-22(;(\!$.%!]V]!+.!'1(!>-9!.(9'!'-!:-&#!V.%!01-+0(!F-22(;(<!C?!:-&!
1$E(!,'&%+(%!$'!F$*>#+%;(!>(?-#(\!32($,(!$2,-!B#+'(!'1(!.$*(!-?!:-&#!3#(E+-&,!F-22(;(!+.!'1(!IK9+,'+.;!F-22(;(!N(*>(#,1+3J!,(0'+-.!-.!'1(!#+;1'<! !
!

College Choice Form: to be completed by ALL Applicants. ! ! Existing College Membership

Do not tick the boxes - you must write a number to show your order of preference. ! C?!:-&!$#(!$2#($%:!$!*(*>(#!-?!$!F$*>#+%;(!
! F-22(;(\!please indicate which one<!=1+,!+,!?-#!
! F1#+,'J,! ! G-*(#'-.! ! `&((.,J!
'1(!b-$#%J,!+.?-#*$'+-.!-.2:\!$.%!%-(,!.-'!
! F1&#01+22! ! G&;1(,!G$22! ! 6->+.,-.! 0-.,'+'&'(!$.!$332+0$'+-.!'-!'1(!F-22(;(<!
!

! F2$#(! ! Y(,&,! ! /'!F$'1$#+.(J,! College

!
Name !
! F2$#(!G$22! ! R+.;J,! ! /'!K%*&.%J,!
If you wish your application to be considered
! F-#3&,!F1#+,'+! ! L&0:!F$E(.%+,1!_! ! /'!Y-1.J, by this College, you must also name it as one
! 7$#B+.! ! N$;%$2(.(! ! /(2B:.! of your choices in the College Choice Form
on the left.
! 7-B.+.;! ! N&##$:!K%B$#%,!_! ! /+%.(:!/&,,(9! P-&!,1-&2%!0-.'$0'!'1+,!F-22(;(!+?!:-&!0-.,+%(#!
!
! K**$.&(2! ! (formerly New Hall) ! =#+.+':! .$*+.;!$.-'1(#!F-22(;(!$,!?+#,'!01-+0(<!
CONTINUING STUDENTS:
! 4+'^B+22+$*! ! Q(B.1$*!_! ! =#+.+':!G$22!
C?!:-&!$#(O1$E(!>((.!$!3-,';#$%&$'(!,'&%(.'!$'!
! "+#'-.! ! S(*>#-A(! ! a-2?,-.! F$*>#+%;(\!32($,(!,((!'1(!b-$#%J,!B(>,+'(!
#(;$#%+.;!:-&#!F-22(;(!01-+0(T!
! "-.E+22(!$.%!F$+&,! ! S('(#1-&,(! ! M3(.!)332+0$'+-.! BBB<$%*+.<0$*<$0<&AO-??+0(,O;#$%,'&%O0&##(.'O0-.'+.&+.;!
! ! !
!!!
!

! _!Colleges for women only! ! !

!

A(5) Current Study:!

=+0A!-.(T! ! C!$*!.-'!0&##(.'2:!,'&%:+.;!c!;-!'-!A(6)! ! !
! C!$*!0&##(.'2:!#(;+,'(#(%!$'!$.-'1(#!+.,'+'&'+-.\!-#!$*!$.!!
! &.%(#;#$%&$'(!-#!;#$%&$'(!,'&%(.'!$'!'1(!D.+E(#,+':!-?!F$*>#+%;(\!$,!?-22-B,T!
!
Name of University Subject Degree Date started Date to be Expected
5+.02&%(!0-&.'#:8! 5+.02&%(!4$0&2':O7(3$#'*(.'8! obtained Grade
! ! ! ! ! !

!
!
A(6): Previous degree-level study (most recent first):!

Name of University Subject Degree Date started Date Grade

5+.02&%(!0-&.'#:8! 5+.02&%(!4$0&2':O7(3$#'*(.'8! obtained
! ! ! ! ! !

!
C?!:-&!1$E(!B-#A(%!-.!$!#(,($#01!3#-d(0'\!(+'1(#!?-#!:-&#!?+#,'!%(;#((!-#!,&>,(@&(.'2:\!32($,(!%(,0#+>(!:-&#!B-#A!>(2-B[!:-&#!$00-&.'!,1-&2%!>(!
+.'(22+;+>2(!'-!$.:-.(!B1-!+,!.-'!$!,3(0+$2+,'!+.!:-&#!?+(2%<!C?!:-&!1$E(!.-!,&01!#(,($#01!(93(#+(.0(\!2($E(!'1+,!,3$0(!>2$.A[!$!>2$.A!(.'#:!B+22!.-'!
3#(d&%+0(!:-&#!$332+0$'+-.<!

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A(7) Scholarships, prizes and other distinctions obtained (list only the most important):!

Name of award Reason for award Date of award Value of award, if any
! ! ! !

! ! ! !

! ! ! !
!

!
A(8) If you have made other applications to Cambridge this year, give details here:!

Degree Programme of study or research area Department

! ! !

! ! !
!

!
A(9) If you have made applications to other institutions this year, give details here:!

Degree Major subject Institution Faculty Country

! ! ! ! !

! ! ! ! !
!
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A(10) Employment History!

From To Post Held Name and Address of Employer

! ! ! !

! ! ! !

! ! ! !

Are you currently employed? P(,! ! Q-! !

! ! !
Will you be employed at least 40% full-time by the University of Cambridge while studying for this course? P(,! ! Q-! !
! ! ! !
!
A(11) Names and addresses of your academic referees:!

! First academic referee ! Second academic referee

5)LL!F)Q7C7)=K/8! 5)7NC//CMQ/!F)Q7C7)=K/!MQLP8!

Q$*(! ! !

=+'2(! ! !

)%%#(,,! ! !

! ! !

=-B.!-#!0+':! ! !

F-&.':O/'$'(!-#!S#-E+.0(! ! !

F-&.'#:! ! !

S-,'$2!F-%(! ! !

K*$+2! ! !
! !
! ! !
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A(12) Summary details of research proposal or reason for applying for the course!

C?!:-&!B+,1!'-!B-#A!&.%(#!$!3$#'+0&2$#!,&3(#E+,-#\!,'$'(!'1$'!3(#,-.J,!.$*(!1(#(T! !
!
! )332+0$.',!?-#!S17\!N/0!-#!NL+''!-.2:<!

=+'2(!$.%!,'$'(*(.'!-?!:-&#!#(,($#01!%(;#((!3#-3-,$2\!-#!#($,-.!?-#!B$.'+.;!'-!&.%(#'$A(!'1(!0-&#,(T!

!
A(13) Part-time research degrees!

C?!:-&!3#-3-,(!'-!,'&%:!?-#!$!3$#'Z'+*(!#(,($#01!%(;#((\!32($,(!,'$'(!:-&#!#($,-.,!?-#!B+,1+.;!'-!
,'&%:!part-time 1(#(<!C?!:-&!+.'(.%!'-!#(*$+.!+.!(*32-:*(.'!B1+2(!,'&%:+.;\!;+E(!%('$+2,<!

!
A(14) Additional information in support of your application!

!
A(15) Career goals and future aspirations!

S2($,(!;+E(!$.!-&'2+.(!-?!:-&#!?&'&#(!0$#((#!32$.,!$.%!+.'(.'+-.,!$.%!(932$+.!1-B!:-&#!3#-3-,(%!,'&%+(,!+.!F$*>#+%;(!B+22!1(23!:-&!
$01+(E(!'1(,(!$+*,<!

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SECTION B
To be completed by all applicants who wish to be considered for awards offered by the Cambridge Trusts
!

=1(!F$*>#+%;(!=#&,',!5B1+01!+.02&%(!'1(!"$'(,!F$*>#+%;(!=#&,'\!'1(!F$*>#+%;(!F-**-.B($2'1!=#&,'\!'1(!F$*>#+%;(!ME(#,($,!=#&,'\!
$.%!$,,-0+$'(%!'#&,',!$.%!'1(+#!0-22$>-#$'-#,8!-??(#!,01-2$#,1+3,!$.%!3$#'Z0-,'!>&#,$#+(,!'-!,'&%(.',!?#-*!-E(#,($,!$.%!'1(!K&#-3($.!D.+-.
5(902&%+.;!'1(!D.+'(%!R+.;%-*8!B1-!;$+.!$%*+,,+-.!'-!'1(!D.+E(#,+':!-?!F$*>#+%;(<!/((!'1(!"#$%&$'(!/'&%+(,!S#-,3(0'&,!?-#!?&#'1(#!+.?-#*$'+-.!
$>-&'!'1(!=#&,',!$.%!'1(+#!$B$#%,<!

•! C?!:-&!$#(!eligible!5+<(<!:-&!$#(!02$,,(%!$,!$.!I-E(#,($,J!-#!IK&#-3($.!D.+-.J!,'&%(.'!?-#!'1(!3&#3-,(,!-?!?((,8!$.%!B+,1!'-!
$332:!?-#!?+.$.0+$2!$+%!?#-*!'1(!F$*>#+%;(!=#&,',!32($,(!'+0A!'1+,!>-9!$.%!0-*32('(!all of section B!$,!?&22:!$,!3-,,+>2(<! !

•! C?!:-&!$#(!not!(2+;+>2(!?-#!$B$#%,!-??(#(%!>:!'1(!F$*>#+%;(!=#&,',!5+<(<!:-&!$#(!$!I1-*(J!,'&%(.'!?-#!'1(!3&#3-,(,!-?!?((,8!
32($,(!'+0A!'1+,!>-9!$.%!0-*32('(!,(0'+-.!B(3) -.2:<! !

•! C?!:-&!have already secured full funding!?-#!:-&#!(.'+#(!0-&#,(!$'!F$*>#+%;(!$.%!do not wish to apply for funding
offered by the Cambridge Trusts!32($,(!'+0A!'1+,!>-9!$.%!;+E(!%('$+2,!-?!'1(!?&.%+.;!:-&!1$E(!,(0&#(%!+.!,(0'+-.!B(3)<! !
!

4-#!+.?-#*$'+-.!$>-&'!:-&#!?((!,'$'&,!32($,(!,((!'1(!"#$%&$'(!/'&%+(,!S#-,3(0'&,<!C.?-#*$'+-.!3#-E+%(%!+.!/(0'+-.!b!-?!'1+,!?-#*!B+22!
.-'!>(!'$A(.!+.'-!$00-&.'!B1(.!0-.,+%(#+.;!:-&#!$0$%(*+0!$332+0$'+-.!?-#!$!32$0(<!
!
B(1) Estimated ANNUAL financial commitment in £ sterling required for your proposed course of study or research at
Cambridge (consult the Graduate Studies Prospectus for the likely annual costs of the course for which you are applying):!

D.+E(#,+':!F-*3-,+'+-.!4((!5$..&$2!$*-&.'8! e!

F-22(;(!?((!5estimated $..&$2!$*-&.'8! e!

N$+.'(.$.0(!$22-B$.0(!5$..&$2!$*-&.'8! e!

! !

Total estimated ANNUAL financial commitment required! e!

!
!
B(2) Funds you are confident of raising ANNUALLY
Please give as much detail as possible of the funds you are able to raise annually!
!
Source! £ a year
!

Family contribution
32($,(!;+E(!,-&#0(\!
! ! e!
+<(<!?#-*!+.0-*(\!
,$E+.;,\!0$3+'$2\!('0<!
!

Personal funds
32($,(!;+E(!,-&#0(\!
! e!
+<(<!?#-*!+.0-*(\!
,$E+.;,\!0$3+'$2\!('0<!
!

Loans
32($,(!;+E(!,-&#0(\!
! e!
+<(<!;-E(#.*(.'\!
,'&%(.'\!>$.A!2-$.\!-'1(#!('0<!
!

Other sources
+.02&%+.;!-'1(#!,01-2$#,1+3,O;#$.',!
! e!
5,&**$#+,(!'1(!$.,B(#,!1(#(!+.!,(0'+-.!
b5f8!>(2-B8!
! !
!

Total funds available ANNUALLY towards financial commitment! e!

ANTICIPATED ANNUAL SHORTFALL, if any, between funds available and financial commitment! e!

!!

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B(3) Applications for other scholarships/awards for which you are under consideration or have been awarded!

G$E(!:-&!$332+(%!-#!$#(!:-&!3#-3-,+.;!'-!$332:!?-#!$.:!-'1(#!$B$#%,H!! ! P(,! ! ! Q-! ! If ‘yes’ please give details below!

Awarding body Tenable at Awarded? Tenure Date awarded/ Annual Value £

Cambridge? Y/N (years) To be awarded
! ! ! ! ! !
! ! ! ! ! !
! ! ! ! ! !
! ! ! ! ! !
! ! ! ! ! !
! ! ! ! ! !
! ! ! ! ! !
!
Note
)332+0$.',!*&,'!A((3!'1(!F$*>#+%;(!=#&,',!$.%!'1(!b-$#%!-?!"#$%&$'(!/'&%+(,!+.?-#*(%!+?!'1(#(!$#(!$.:!01$.;(,!'-!'1(!+.?-#*$'+-.!;+E(.!+.!
questions B(2) and B(3)<!C.!3$#'+0&2$#\!'1(:!*&,'!+.?-#*!>-'1!'1(!F$*>#+%;(!=#&,',!$.%!'1(!b-$#%\!B+'1!?&22!*-.('$#:!3$#'+0&2$#,\!+?!'1(:!B+.!$.:!
$B$#%!'(.$>2(!$'!F$*>#+%;(!?-#!B1+01!'1(:!1$E(!$2#($%:!$332+(%!-#!B1+01!'1(:!$#(!$B$#%(%!,&>,(@&(.'!'-!'1+,!$332+0$'+-.<!
!
B(4) Application to the Cambridge Trusts (overseas and EU candidates only)!

Have you applied to the Cambridge Trusts for a scholarship/bursary before?! ! P(, Q- !

!
C?!:(,\!?-#!B1+01!:($#!-?!(.'#:!'-!'1(!D.+E(#,+':H! !
!
!

Have you received a scholarship/bursary from the Cambridge Trusts before?! P(,! !
! ! Q-!
! ! !

C?!:(,\!32($,(!,3(0+?:!>(2-B!B+'1!%('$+2,!$.%!%$'(,<!

!
!
B(5) Personal reference!

Personal referee!5MgK6/K)/!)Q7!KD!F)Q7C7)=K/!)SSLPCQ"!=M!F)Nb6C7"K!=6D/=/!MQLP8!

Q$*(! ! =+'2(!5N#ON#,ON+,,O7#!('08!!
!
)%%#(,,! !

! !

! !

=-B.!-#!0+':! !

F-&.':O/'$'(!-#!S#-E+.0(! !

F-&.'#:! !

S-,'$2!F-%(! !

! ! !
K*$+2! !
!
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!
!
!
!
!
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!
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B(6) Personal statement!

C.!.-'!*-#(!'1$.!XWW!B-#%,\!32($,(!%(,0#+>(!1-B!:-&#!+.'(#(,',!$.%!$01+(E(*(.',\!>-'1!$0$%(*+0!$.%!(9'#$Z0&##+0&2$#\!%(*-.,'#$'(!$!0$3$0+':!?-#!
2($%(#,1+3!$.%!$!0-**+'*(.'!'-!+*3#-E+.;!'1(!2+E(,!-?!-'1(#,<!C andidates who wish to be considered for awards offered by the Cambridge
Trusts MUST complete this section. S2($,(!.-'(!'1$'!'1+,!+.?-#*$'+-.!+,!QM=!0-.,+%(#(%!$,!3$#'!-?!:-&#!$332+0$'+-.!?-#!$%*+,,+-.!'-!'1(!0-&#,(<!

!
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SECTION C
To be completed by all applicants
!

C(1) Next of kin!

Q$*(! ! !

)%%#(,,! !

! !

! !

=-B.!-#!0+':! !

F-&.':\!3#-E+.0(!-#!,'$'(! !

S-,'0-%(OF-&.'#:! !

=(2(31-.(! !

! ! ! !
!
C(2) How did you hear about graduate programmes at Cambridge?
e.g. Prospectus, Internet, British Council, Careers Service etc (please specify)

!
C(3) Declaration and Data Protection!

=1+,! %-0&*(.'! ?-#*,! '1(! 2(;$2! >$,+,! -?! :-&#! $332+0$'+-.! '-! F$*>#+%;(<! a(! #(,(#E(! '1(! #+;1'! '-! #(?&,(! $%*+,,+-.! +.! '1(! (E(.'! -?! $.:!
*+,#(3#(,(.'$'+-.!>:!:-&<!/&>*+,,+-.!-?!$.!$332+0$'+-.!%-(,!.-'!+*32:!$.!-??(#!-?!$%*+,,+-.<!6($%!'1(!?-22-B+.;!,'$'(*(.'!0$#(?&22:!>(?-#(!
:-&!,+;.!:-&#!$332+0$'+-.<!We cannot accept your application without your signature and the date below.!
! !
U! 7)=)! S6M=KF=CMQ! )F=! 5Uhhi8T! C! $;#((! '-! '1(! D.+E(#,+':! -?! F$*>#+%;(\! 0-22(;(,! -?! '1(! D.+E(#,+':! -?! F$*>#+%;(\! "$'(,!
F$*>#+%;(!=#&,'!$.%!'1(!F$*>#+%;(!F-**-.B($2'1\!-#!ME(#,($,!=#&,'!5$,!$33#-3#+$'(8!3#-0(,,+.;!3(#,-.$2!%$'$!0-.'$+.(%!+.
*:!$332+0$'+-.!3$3(#,!B1('1(#!3#-E+%(%!+.!0-.?+%(.0(!-#!.-'!!>:!-'1(#!+.%+E+%&$2,!-#!+.,'+'&'+-.,\!+.!,&33-#'!-?!*:!$332+0$'+-.\! $,
3$#'!-?!'1(!$%*+,,+-.,\!#(;+,'#$'+-.!$.%!?&.%+.;!3#-0(,,(,<!C!#(0-;.+,(!'1$'!,-*(!-?!'1(!+.?-#*$'+-.!#(0(+E(%!>:!'1(! D.+E(#,+':!-?
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C(4) SUBMISSION!

=1+,!?-#*!+,!-.2:!3$#'!-?!:-&#!$332+0$'+-.!'-!F$*>#+%;(<!7-!.-'!,&>*+'!+'!B+'1-&'!'1(!-'1(#!+.?-#*$'+-.!B(!#(@&+#(<!6($%!'1(!+.,'#&0'+-.,!?-#!
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www.hesa.ac.uk/index.php/content/view/141/171!
!
!

)!?((!-?!GBP £35!?-#!($01!;#$%&$'(!$%*+,,+-.!$332+0$'+-.!+,!$332+0$>2(<!!!
!

Applications without payment will not be processed.

!

F-*32('(%!3$3(#!$332+0$'+-.,!*&,'!>(!$00-*3$.+(%!>:!$!01(@&(!-#!>$.A(#J,!%#$?'!?-#!G BP £35!*$%(!3$:$>2(!'-!IThe University of CambridgeJ!

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!

Your full name, address, date of birth and details of the course applied for must be written on the back of the banker’s draft or cheque.

! PAGE 8 OF 8!
!

S(#,-.$2!7$'$!/1(('!
!

!
Board of Graduate Studies!
! !
!
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Note: there are two sides to this form.!
!
Name ! ! !
(legal)
L$,'!5?$*+2:8! 4+#,'!$.%!-'1(#!53(#,-.$28! =+'2(!5N#ON#,ON+,,O7#!('08!
!

(1) About your family while you are in Cambridge

S2($,(! ;+E(! %('$+2,! 1(#(! >:! '+0A+.;! '1(! $33#-3#+$'(! >-9(,! $.%! ;+E+.;! '1(! ?&#'1(#! +.?-#*$'+-.! #(@&(,'(%<! C?! B(! *$A(! :-&! $.! -??(#\! B(! ,1$22!
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! C!,1$22!>#+.;!$!3$#'.(#!-#!,3-&,(! Name of partner or spouse_T!!

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C,!1(O,1(!$2,-!$332:+.;!?-#!;#$%&$'(!,'&%:!$'!F$*>#+%;(H!(tick box)
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! C!,1$22!>#+.;!-.(!01+2%! Date of birth: (DD/MM/YYYY)

! C!,1$22!>#+.;!$!,(0-.%!01+2%! Date of birth: (DD/MM/YYYY)

! C!,1$22!>#+.;!$!'1+#%!01+2%! Date of birth: (DD/MM/YYYY)

!
a+22!$22!'1(!3(-32(!+.%+0$'(%!>(!?+.$.0+$22:!%(3(.%(.'!-.!:-&H!!! ! P(,! ! Q-! If no, please give details below:
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(2) Support needs relating to disability or chronic illness

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!
! ! !

(CONTINUES OVERLEAF)
!

!
! 4DLL!Q)NK! !
!
(3) Ethnic Origin

Please tick the appropriate box to indicate your background. If you do not wish to provide information in this section, tick the ‘Information
refused’ box.!
!

! a1+'(!!5UW8!

! b2$0A!-#!b2$0A!b#+'+,1!c!F$#+>>($.!5VU8!

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! N+9(%Za1+'(!$.%!),+$.!5jf8!

! M'1(#!N+9(%!>$0A;#-&.%!5jh8!

! M'1(#!K'1.+0!>$0A;#-&.%!5iW8!

! C.?-#*$'+-.!#(?&,(%!5hi8!
!
!
(3) About your financial situation

5=1+,!+.?-#*$'+-.!+,!1(23?&2!'-!F-22(;(,!B1-!.((%!'-!(,'+*$'(!'1(!2+A(2+1--%!-?!:-&!>(+.;!$>2(!'-!'$A(!&3!:-&#!32$0(8!!
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!

! P(,!
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! Q-!
!
!
!
!
!
!
!
!
!
!
!
! !

/+;.$'&#(! 7$'(!

!
!
!
!
!
!
!
!
!
!
!
!
For applicants for )0$%(*+0!6(?(#(.0(!
admission only
(not continuation C.,'#&0'+-.!4-#*!U
or re-admission)
Board of Graduate Studies !

INSTRUCTIONS FOR A REFEREE SUPPORTING AN APPLICATION FOR ADMISSION

(1) To be completed by the applicant!

Applicant’s Name Proposed Study

L$,'!5?$*+2:8! ! 7(;#((!=:3(! ! !! !4&22!=+*(!! !S$#'!=+*(
! !

4+#,'!53(#,-.$28! !
S#-;#$**(!-?!,'&%:! !
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! !

Contact Details! 7(3$#'*(.'! !

K*$+2! ! ! !

! ! ! ! ! ! ! !
=(2(31-.(! ! )332+0$'+-.!Q&*>(#!
!

Date of Birth ! Sex Applicant’s Signature

! ! !

! !
! ! !

! !N$2(!!!!!!! !
77! NN! PPPP!
! !4(*$2(! /+;.$'&#(! ! 7$'(!577ONNOPPPP8
!
(2) To be completed by the referee!

Referee’s Name Referee’s Contact Details

Q$*(! ! K*$+2! !
S-,+'+-.! ! =(2(31-.(! !

Institution )%%#(,,! !
C.,'+'&'+-.!Q$*(! ! F+':! !
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!

The paper should be the letterhead of your institution: if you are not able to use a letterhead, please attach your business
card. The reference should also be signed, as we cannot accept electronic or scanned signatures. Please address references
to ‘The Secretary of the Board of Graduate Studies’ and make sure you sign and date the reference.
S2($,(!0-**(.'!-.!'1(!$332+0$.'J,!$0$%(*+0!?+'.(,,!$.%!;(.(#$2!,&+'$>+2+':!'-!&.%(#'$A(!'1(!3#-3-,(%!0-&#,(!-?!#(,($#01!-#!,'&%:\!+.!
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!
(3) DECLARATION AND DATA PROTECTION

7)=)!S6M=KF=CMQ!)F=!5Uhhi8T!S2($,(!+.%+0$'(\!>:!'+0A+.;!!'1(!>-9!>(2-B\!+?!:-&!$;#((!'-!'1+,!#(?(#(.0(!>(+.;!#(2($,(%!'-!'1(!3(#,-.!+.!#(,3(0'
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!

! !

6(?(#((J,!/+;.$'&#(! 7$'(!577ONNOPPPP8!

(4) DELIVERY

To deliver, please:
U8!K.02-,(!'B-!0-3+(,!5DR!$332+0$.',8!-#!'1#((!0-3+(,!5.-.ZDR!$332+0$.',8!-?!#(?(#(.0(!+.!$!/K)LK7!(.E(2-3(<!
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!

f8!6('&#.!'1(!(.E(2-3(!'-!'1(!$332+0$.'<!Please do not send it direct to the University of Cambridge<!

!
NOTES
For applicants for )0$%(*+0!6(?(#(.0(!
admission only
(not continuation C.,'#&0'+-.!4-#*!V
or re-admission)
Board of Graduate Studies !

INSTRUCTIONS FOR A REFEREE SUPPORTING AN APPLICATION FOR ADMISSION

(1) To be completed by the applicant!

Applicant’s Name Proposed Study

L$,'!5?$*+2:8! ! 7(;#((!=:3(! ! !! !4&22!=+*(!! !S$#'!=+*(
! !

4+#,'!53(#,-.$28! !
S#-;#$**(!-?!,'&%:! !
=+'2(!! ! !!!5N#ON#,ON+,,O7#!('08! -#!#(,($#01!$#($!
! !

Contact Details! 7(3$#'*(.'! !

K*$+2! ! ! !

! ! ! ! ! ! ! !
=(2(31-.(! ! )332+0$'+-.!Q&*>(#!
!

Date of Birth ! Sex Applicant’s Signature

! ! !

! !
! ! !

! !N$2(!!!!!!! !
77! NN! PPPP!
! !4(*$2(! /+;.$'&#(! ! 7$'(!577ONNOPPPP8
!
(2) To be completed by the referee!

Referee’s Name Referee’s Contact Details

Q$*(! ! K*$+2! !
S-,+'+-.! ! =(2(31-.(! !

Institution )%%#(,,! !
C.,'+'&'+-.!Q$*(! ! F+':! !
7(3'O4$0&2':! ! F-&.'#:! !

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!

The paper should be the letterhead of your institution: if you are not able to use a letterhead, please attach your business
card. The reference should also be signed, as we cannot accept electronic or scanned signatures. Please address references
to ‘The Secretary of the Board of Graduate Studies’ and make sure you sign and date the reference.
S2($,(!0-**(.'!-.!'1(!$332+0$.'J,!$0$%(*+0!?+'.(,,!$.%!;(.(#$2!,&+'$>+2+':!'-!&.%(#'$A(!'1(!3#-3-,(%!0-&#,(!-?!#(,($#01!-#!,'&%:\!+.!
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!
(3) DECLARATION AND DATA PROTECTION

7)=)!S6M=KF=CMQ!)F=!5Uhhi8T!S2($,(!+.%+0$'(\!>:!'+0A+.;!!'1(!>-9!>(2-B\!+?!:-&!$;#((!'-!'1+,!#(?(#(.0(!>(+.;!#(2($,(%!'-!'1(!3(#,-.!+.!#(,3(0'
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!

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!

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!

! !

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(4) DELIVERY

To deliver, please:
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!
NOTES
 S(#,-.$2!6(?(#(.0(!4-#*

Board of Graduate Studies !

(1) To be completed by the applicant!

Applicant’s Name Proposed Study

L$,'!5?$*+2:8! ! 7(;#((!=:3(! ! !! !4&22!=+*(!! !S$#'!=+*(!
!

!
!

4+#,'!53(#,-.$28!
S#-;#$**(!-?!,'&%:! !
=+'2(!! ! !!!5N#ON#,ON+,,O7#!('08! -#!#(,($#01!$#($!
! !

Contact Details! 7(3$#'*(.'! !

K*$+2! !
! !

)332+0$'+-.!Q&*>(#!! ! ! ! ! ! ! ! !
=(2(31-.(! ! (if already available)! !

Date of Birth ! Sex Applicant’s Signature

! ! !

!
! ! !

! !N$2(!!!!!!! !
77! NN! PPPP!
! !4(*$2(! /+;.$'&#(! ! 7$'(!577ONNOPPPP8

!
(2) To be completed by the referee!

Referee’s Name Referee’s Contact Details

Q$*(! ! K*$+2! !
S-,+'+-.! ! =(2(31-.(! !

Institution )%%#(,,! !
C.,'+'&'+-.!Q$*(! ! F+':! !
F-&.'#:! !

G-B!2-.;!1$E(!:-&!A.-B.!'1(!$332+0$.'H!
C.!B1$'!0-.'(9'!%-!:-&!A.-B!1+*O1(#H!

!
(3) Assessment

Please give below your candid assessment of the applicant’s personal and social qualities, achievements, future plans and any other
factors relevant to the application for awards from the Trusts. The Trustees are looking for applicants with outstanding academic
records but also with personal qualities that mark them out as potential leaders capable of making significant contributions to
society. The Trustees attach the greatest importance to the personal reference, warmly thank referees in advance for their help and
apologise that the number of applications prevents them from acknowledging receipt of this reference.

G-B!1+;12:\!>:!'1(!*-,'!,'#+.;(.'!B-#2%B+%(!,'$.%$#%\!B-&2%!:-&!#$'(!'1(!$332+0$.'!?-#!$.!$B$#%!?#-*!'1(!F$*>#+%;(!=#&,',\!>($#+.;!+.!*+.%!'1(!
,'#(.;'1!-?!'1(!0-*3('+'+-.H!

Tick as appropriate Comments

K90(3'+-.$2!

! /'#-.;!

6(,3(0'$>2(!

Q-'!/'#-.;!

)#(!'1(!$332+0$.'J,!@&$2+?+0$'+-.,!$33#-3#+$'(!?-#!'1(!0-&#,(!-?!;#$%&$'(!,'&%:!-#!#(,($#01!$'!F$*>#+%;(\!$.%!+.!B1$'!B$:,!B+22!'1(!
3#-3-,(%!,'&%:!>(!#(2(E$.'!'-!'1(!.((%!-?!'1(!$332+0$.'J,!0-&.'#:H!

!
(4) Reference

Please give below your assessment of the applicant’s leadership potential and commitment to improving the lives of others. Please
attach a separate letter if necessary.

!
(5) DECLARATION AND DATA PROTECTION

7)=)!S6M=KF=CMQ!)F=!5Uhhi8T!S2($,(!+.%+0$'(\!>:!'+0A+.;!'1(!>-9!>(2-B\!+?!:-&!$;#((!'-!'1+,!#(?(#(.0(!>(+.;!#(2($,(%!'-!'1(!3(#,-.!+.!#(,3(0'
!-?!B1-*!+'!+,!B#+''(.\!,1-&2%!'1$'!3(#,-.!,((A!+',!%+,02-,&#(<!C?!:-&!%-!.-'!+.%+0$'(!$!3#(?(#(.0(!>(2-B\!B(!B+22!$,,&*(!'1$'!:-&!%-!.-'!$;#((!'-!'1(
!%+,02-,&#(!-?!:-&#!#(?(#(.0(!+?!'1(!3(#,-.!0-.0(#.(%!,((A,!+',!%+,02-,&#(<!S2($,(!.-'(!'1$'!'1(#(!*+;1'!>(!0+#0&*,'$.0(,!&.%(#!B1+01!'1(!
D.+E(#,+':!B-&2%!>(!#(@&+#(%!'-!*$A(!$!%+,02-,&#(!+##(,3(0'+E(!-?!:-&#!B+,1(,<!C.!,&01!$!0$,(\!:-&#!.$*(!B-&2%!.-'!>(!%+,02-,(%<!G-B(E(#\!!
'1(!D.+E(#,+':!B+22!'#($'!:-&#!#(?(#(.0(!+.!,'#+0'!0-.?+%(.0(!+.,-?$#!$,!'1(!2$B!3(#*+',<!
!!

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!

C!0-.?+#*!'1$'!'1(!+.?-#*$'+-.!;+E(.!$>-E(!$.%!-.!'1(!$33(.%(%!#(?(#(.0(!2(''(#!+,!$00&#$'(!'-!'1(!>(,'!-?!*:!A.-B2(%;(!$.%!&.%(#,'$.%!
'1$'!'1(!D.+E(#,+':!-?!F$*>#+%;(!*$:!#(?&,(!$%*+,,+-.!+?!+'!%+,0-E(#,!'1$'!$.:!+.?-#*$'+-.!;+E(.!1$,!>((.!?$2,+?+(%!-#!+,!+.$00&#$'(<!
!

! !

6(?(#((J,!/+;.$'&#(! 7$'(!577ONNOPPPP8!

!
(6) DELIVERY:

To deliver, please:
U8!K.02-,(!-.(!0-3:!-?!'1(!3(#,-.$2!#(?(#(.0(!+.!$!/K)LK7!(.E(2-3(<!
!

V8!/+;.!:-&#!.$*(!$0#-,,!'1(!,($2!$.%!0-E(#!+'!B+'1!02($#!'$3(<!
!

f8!F2($#2:!B#+'(!mSK6/MQ)L!6K4K6KQFK!MQ!bKG)L4!M4!nF)Q7C7)=KJ/!Q)NKop!-.!'1(!?#-.'!-?!'1(!(.E(2-3(<!
!

j8!6('&#.!'1(!(.E(2-3(!'-!'1(!$332+0$.'<!Please do not send it direct to the University of Cambridge<!

!
 Board of Graduate Studies

GRADUATE APPLICATION CHECKLIST

GRADUATE APPLICATION CHECKLIST
GRADUATE APPLICATION CHECKLIST
NOTES