CBT BiP Application Form
For more information, you can visit
https://www.queens.ac.uk/
Which year in September, would you like to start the BiP programme?
*
1. PERSONAL DETAILS
Name:
*
First Name
Last Name
Date of Birth:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Address:
*
Street Address
Street Address Line 2
Town/City
Postcode
Country
Telephone
*
Please enter a valid phone number.
Format: (07000) 000-000.
Landline:
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Area Code
Phone Number
Email:
*
example@example.com
Church Denomination or tradition (if applicable):
Are you a UK/EU citizen or have the right to study in the UK on other grounds?
*
Please Select
Yes
No
Unsure
2. ACADEMIC HISTORY
Education gained from Schools, College and University (Please start with your most recent qualifications)
*
Rows
Dates of Attendance
School College University Attended
The official name of the Diploma/Degree
Awarding Body/Exam Board
Level or Grade
Date of Award
From -To
From - To
From - To
From - To
From - To
From - To
3. RESEARCH PRACTICALITIES
How do you plan to study? Please tick
*
Part Time
Full Time
Unknown
4. FINANCE AND FUNDING
Please tick below the method by which you intend to finance your research studies. (Further information will be provided to you on each option and evidence will need to be supplied in due course.)
*
Self-Funded
Combined Funding
Church Sponsor
Employer Sponsor
5. RESEARCH INTEREST
Tell us in approximately 500 words about your motivation to do research. Include your initial thoughts about your topic or area of interest and provide a list of references.
*
0/550
6. FURTHER SUPPORTING INFORMATION
Are there other life experiences or circumstances that are relevant to this application that you would like to share?
0/500
7. PLEASE PROVIDE THE NAME AND CONTACT DETAILS OF TWO REFEREES
Referee 1. Full Name
*
Referee 1. Email
*
example@example.com
Referee 1. Phone Number
*
Please enter a valid phone number.
Format: (07000) 000-000.
Referee 1. Role/Relationship
*
Referee 2. Full Name
*
Referee 2. Email
*
example@example.com
Referee 2. Phone Number
*
Please enter a valid phone number.
Format: (07000) 000-000.
Referee 2. Role/Relationship
*
Signature
*
Please use your mouse to add your signature here
Date
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Today's date
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