application-form-ian-coulson-award

Application for the Ian Coulson Memorial Postgraduate Award
Complete application and submit the printed form to Professor Jackie Eales, Centre for Kent History and Heritage,
School of Humanities, Canterbury Christ Church University, North Holmes Road, Canterbury CT1 1QU or by scanning
and e-mailing to by the 28th February or 31st August
Student Information
Application/CCCU Student Number:
Title

Forename

Middle name(s)

Family name

Previous name (if any)

Male/Female

Date of Birth (dd/mm/yyyy)

Postal address

Email address

Phone number

Residency status
Nationality
Please state the country in which you are normally resident
Do you require a Tier 4 visa?

Your career in higher education to date
Undergraduate Study

Name of university or college & country (if
not UK)
Mode of attendance (Full or Part Time)
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Postgraduate Study


Month and year in which your course started
and finished (or will finish)

Start date

End date

Start date

Subject of study
Level of study (for example Undergraduate)
Qualification gained (with overall result)
(for example, BA 1st class Honours). For nonUK degrees, please give the title of the
degree in the original language

Professional experience that is relevant to this application
Dates
(month and year)
From

To

Full or part-time

Employer/Organisation (including
location)

Status and responsibilities

Case for Award
Please give the title of the course, for which you have an unconditional offer:

Please make your case for the award in the space below
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End date


In presenting your case, you should consider the following points:
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


How will taking this course develop your professional or academic expertise and contribute to your long-term
career aims?
Describe any special area of Kent interest you wish to pursue at this University within your chosen programme, in
particular using regional collections and archives.
How well prepared are you to undertake this course?

Signature

Date

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