Research Degrees Application Form

Please complete this form in BLOCK CAPITALS

Course details
Subject area

__________________________________________________________

Award title

MPhil

MPhil/PhD

PhD

DProf Health & Social Care

DProf Practical Theology
MProf
Mode of study

DBA

DProf Science & Technology

DProf Laws

DProf Applied Linguistics

PG Dip Professional Research

Full-time

EdD

Part -time

MD(Res)

Proposed date of entry

Personal details
Title________________________________________________________

Male/Female

Surname/Family name____________________________________
Previous surname_______________________________________
First name(s)___________________________________________
Date of birth (dd-mm-yy)

Permanent home address * (see note)

Contact address (if different from home address)

___________________________________

___________________________________

___________________________________

___________________________________

___________________________________

___________________________________

___________________________________

___________________________________

Postcode

Postcode

Telephone no._______________________

Telephone no._______________________

Email address_______________________

Email address_______________________

Fees information
Who is expected to pay your fees?
If you have indicated that a sponsor or
research funding body is expected to
pay your fees, please provide the name
and contact details of the sponsor or
funder.

Yourself

Sponsor

Research funding body

Name and contact details of sponsor/funding body

_______________________________________________
_
_______________________________________________
_
_______________________________________________
_

Further details
Country in which you have unrestricted right to reside/live

______________________________

Country of birth

______________________________

Nationality (as stated on your passport)

______________________________

Have you been permanently resident in the UK/EU for the last three years for other than educational
purposes? Yes
No
Please give date of entry _______________
Do you have any unspent criminal convictions in any country?
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Yes

No

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Passport number (non-UK/EU only) ________________________________________________

Learning support needs

Do you have a disability, medical condition or learning difficulty?

Yes

No

(If your answer is yes Please give brief details; our Student Support Service will contact you
and note that we will require documentary evidence of the above in order to make adjustments
to the learning environment for you.)

__________________________________________________________
__________________________________________________________
Education, qualifications and training
Higher education/Further education/Secondary education (please list most recent first)
Name of institution

From
(mm/yy)

To
(mm/yy)

Full-time?

Continue on separate sheet if necessary

Qualifications completed or relevant training undertaken (please list most recent first)
Qualification

Subject

Grade

Date awarded

Continue on separate sheet if necessary

Qualifications pending or continuing training
Qualification

Subject

Expecte
d grade

Date (mm/yy)

Continue on separate sheet if necessary

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Evidence of English language level

For English language level required please visit:
www.anglia.ac.uk/ruskin/en/home/central/rds/services/research_office/research_degrees/prospective_students.html

If youre not native speaker, please complete one of the two options below
Name of last examination taken (eg IELTS or TOEFL)....................................Result
Original/copy of certificate enclosed?
Yes No
If No please
explain
OR Evidence of study through the medium of English enclosed?
Yes No
Professional body membership
Professional body

Date joined

Continue on separate sheet if necessary

Employment
Current employer
Name of organisation____________________________________________________
Address_______________________________________________________________
_______________________________________________________________
Department__________________________

Job title___________________________

Date appointed_______________________
Continue on separate sheet if necessary
Previous employers (please list most recent first)
Organisation

Position held

From (mm/yy)

To (mm/yy)

Continue on separate sheet if necessary

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Supporting information
Outline research proposal
Please indicate in general terms the area of your research interest. Please use the headings below to
form the basis of your outline. Approximately one to two sides of A4 are expected.
For MPhil/PhD/MD(res):
Proposed area of research

Aim and focus of the study

Context for the research

Research methodology, including data collection and analysis

Research skills

Indicative references/publications

For MProf/DProf/DBA/EdD:

Proposed area of research

Professional context

Aim and focus of the study

Significance to you, your employer and professional practice

Approximately one to two sides of A4 are expected.

Outline research proposal
Please insert your research proposal below.

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Our university reserves the right to submit any application to study for a research degree through
TurnitinUK plagiarism detection software.

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Referees Please provide two references on letter headed paper, signed and dated. We require two
academic references to support applications for MPhil and PhD. Applicants for Professional
Doctorates (DBA, EdD and DProf) and MD (Res) are to provide one academic and one professional
reference.
Name of referee 1 .................................................... Name of referee 2 ....................................................
Organisation ............................................................
Relationship to you...................................................
Reference enclosed

Reference to follow

Organisation ............................................................
Relationship to you...................................................
Reference enclosed

Reference to follow

Provisional supervisor If you have discussed your application with a particular academic
member of staff, please state that persons name here
Name____________________________________________________________________
Telephone no._____________________________________________________________
Email address______________________________________________________________
Declarations
Do you have any unspent criminal convictions?

Yes

No

A criminal record will not necessarily be a bar to obtaining a place at Anglia Ruskin University.
A satisfactory Disclosure and Barring Service check will be required for successful applicants to
courses which include placements where students work with children or vulnerable adults.
Data Protection Act 1998
I agree to the University processing personal data contained in this form or other data which the
University may obtain from other people. I agree to the processing of such data for any purposes
connected with my studies or my health and safety whilst on the premises or for any legitimate reason
including communication with me following the completion of my studies.
In addition, I agree to the University processing personal data described as sensitive data within the
meaning of the Data Protection Act 1998, such processing to be undertaken for any purposes as
indicated in the declaration above.
If my employer/sponsor is supporting my studies by paying my fees/allowing me study time I agree to
my employer/sponsor being informed of the progress of my application and of my studies if I am
accepted onto the course.
Agent referral
To be completed if applying with the assistance of an overseas recruitment agent
I confirm that I give the following Anglia Ruskin recruitment partner authorisation to discuss my
application with staff at Anglia Ruskin University, and receive correspondence from Anglia Ruskin
University on my behalf.
Company ................................................................. Contact person
Email ........................................................................ Telephone no ..
Declaration
I certify that, to the best of my belief, the information I have provided is complete and true.
Signature of applicant ........................................................

Date

Signature of guardian ..........................................................

if applicant is under 18 years

Date

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Supporting documentation
Please note that all applicants must include copies of the following when returning this application form:
Academic certificates (officially translated if not UK)

Academic transcripts, including subjects studied and grades achieved (officially translated if not
UK)
English language certificate (if not UK National)

Photocopies of passport to include photograph and personal detail pages.

International applicants currently residing in UK must also provide photocopies of visa and
immigration stamps.

References (as outlined above)

This application will only be processed when the required documentation is received
Please submit your completed application form with supporting documentation as follows:
UK/EU applicants
Email: admissions@anglia.ac.uk
Fax: +44 (0)1245 607520
Post: Admissions Office, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, CM1 1SQ
International applicants
Email: internationaladmissions@anglia.ac.uk
Fax: +44 (0)1245 683690
Post: International Admissions, Anglia Ruskin University, Bishop Hall Lane, Chelmsford,
CM1 1SQ

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