The David Tresman Caminer Postgraduate

Scholarship closing
30 September
2011
Scholarship
indate:
Business
Computing
th

(Supported
by the LEO Foundation and AIT Trust)
Application Form
Application Form, closing date: Monday 22nd September 2014
You are required to have applied for a programme of study in the School of
Engineering & Information Science before this application can be assessed.

Personal Details
Family Name :

First Name(s):

Previous Name:

Gender:

Date of Birth: (DD/MM/YY)

Address:

Male:

Title: (Mr/Mrs etc)

Postcode:

Country:

Tel No:

Mobile:

Email:

Information About Your Programme

Programme
Title:

Year Of
Entry:

Middlesex Student ID:

Month:

Academic History (Name of institution, qualification & date)

Female:

Declaration
Personal Statement

I certify that the above information is correct and I accept that the decision of the Middlesex University
In not more than
500Committee
words, using
the space
tell us about
yourself,
your future
why you
Scholarship
Awards
is final.
Termsbelow,
and Conditions
apply.
Furthermore
any plans,
statements
on
have
chosen
to
study
at
Middlesex
University
and
why
you
merit
a
scholarship.
You
may
use
one
extra
this form which prove to be untrue or purposely misleading will render the application void. If
side of A4 paper,
but please observe
500we
word
limit.
inaccuracies
are highlighted
at a laterthe
stage
retain
the right to retract the scholarship and review
your student status.

The University

reserves the right to use all or part of your personal statement, quotes, photographs or
other materials for publicity and promotional purposes. I consent to the processing of this data by
Middlesex University under the provision of the 1998 Data Protection Act.

Please enclose copies of your Academic Certificates

Signature:

Date:

Please Return Your Completed Application To:

Scholarships & Bursary Officer, Fenella Building,
Middlesex University, The Burroughs, NW4 4BT
Fax: +44 (0)208 203 6105
Email: scholarships@mdx.ac.uk