MA Application Form

Submitted by admin on Wed, 01/26/2011 - 17:37

1. PERSONAL DETAILS

SURNAME: *	FORNAME: *
PERMANENT HOME ADDRESS: *
TOWN: *	POST CODE: *
COUNTRY: *	TELEPHONE: *
MOBILE:	FAX:
Email Address: *

CORRESPONDENCE ADDRESS (if different):
TOWN:	POST CODE:
COUNTRY:	TELEPHONE:
MOBILE:	FAX:
Email Address:

NATIONALITY (as stated in passport): *	PASSPORT NO: *
COUNTRY OF BIRTH: *	DATE OF ENTRY TO UK:
COUNTRY OF PERMANENT RESIDENCE: *	UK VISA EXPIRY DATE:

STATUS: *

Single

Married

DATE OF BIRTH: *

2. FINANCE

PROPOSED SOURCE OF FINANCE: * SELF EMPLOYER OTHER (please list):	(please list):
SCHOLARSHIPS: Please give details of any scholarships or grants for which you are applying, including date(s) of when you will know the result of your application.

3. COURSE DETAILS

DATE OF ADMISSION:
APPLICATION FOR: POSTGRADUATE CERTIFICATE POSTGRADUATE DIPLOMA MA in Islamic Studies MEd in Islamic Education MA in Islamic Banking, Finance and Management
MODE OF STUDY: PART TIME FULL TIME

MA OPTIONAL COURSE UNITS
For Postgraduate Certificate, Postgraduate Diploma and MA applications, please indicate choice of course units. See the prospectus for a full list of course units. Postgraduate Certificate requires 60 credits Postgraduate Diploma requires 120 credits MA requires 180 credits (120 credits from taught modules, including Research Methodology + 60 Credit Dissertation).
Major Units (30 credits):	Minor Units (15 credits):

4. PREVIOUS EDUCATION AND EXPERIENCE

A. SECONDARY EDUCATION

(Please provide copies of certificates and marks transcript)

PLEASE GIVE DETAILS OF QUALIFICATIONS OBTAINED AT HIGH SCHOOL / SECONDARY SCHOOL

Name of Qualification	Examining Body	Subject(s)	Grade / Percentage	Exam Date (mm/yyyy)
Qualification 1:	Examining Body 1:	Subject(s) 1:	Grade / Percentage 1:	Exam Date (mm/yyyy) 1:
Qualification 2:	Examining Body 2:	Subject(s) 2:	Grade / Percentage 2:	Exam Date (mm/yyyy) 2:
Qualification 3:	Examining Body 3:	Subject(s) 3:	Grade / Percentage 3:	Exam Date (mm/yyyy) 3:

B. HIGHER EDUCATION

PLEASE GIVE DETAILS OF UNIVERSITIES/COLLEGES ATTENDED

(Including degrees obtained/courses followed or which are still in progress)

HE Qualifications:

University / College:

HE University:

Address:

HE Address:

From:

HE From:

Course / Degree:

HE Course:

Result/Overall Grade:

HE Result:

C. PROFESSIONAL QUALIFICATIONS OBTAINED

PLEASE GIVE DETAILS OF UNIVERSITIES/COLLEGES ATTENDED

(Including degrees obtained/courses followed or which are still in progress)

Pro Qualifications:

University / College:

Pro University:

Address:

Pro Address:

From:

Pro From:

Course / Degree:

Pro Course:

Result/Overall Grade:

Pro Result:

D. EMPLOYMENT RECORD

PLEASE GIVE DETAILS OF ANY RECENT EMPLOYMENT / WORK EXPERIENCE

Employer:

Employer:

Address:

Emp Address:

Nature of Work:

Nature of Work:

From:

Emp From:

Course / Degree:

Emp Course:

E. PLEASE LIST ANY OTHER CURRICULAR ACTIVITIES OR HOBBIES:

Other Activities:

5. PERSONAL STATEMENT
PLEASE DESCRIBE YOUR ACADEMIC INTERESTS AND REASONS FOR APPLYING FOR THIS COURSE:

6. LANGUAGE ABILITY

WOULD YOU BE INTERESTED IN ANY OF THE FOLLOWING ORIENTATION COURSES?

(to be held in August and September)

ORIENTATION COURSES:

ENGLISH LANGUAGE

QUR’ANIC ARABIC

FUNDAMENTALS OF ISLAM

RESEARCH METHODOLOGY

(Please note that depending on your level of proficiency, such courses may be a compulsory requirement)

7. NEXT OF KIN

PLEASE GIVE DETAILS OF NEXT OF KIN OR SOMEONE WHO CAN BE CONTACTED IN CASE OF EMERGENCY:

NOK Name:
NOK Address:
NOK Country:	NOK Telephone:
NOK Mobile:	NOK Fax:
NOK Email:

8. REFERENCES

PLEASE LIST THE NAMES AND CONTACT DETAILS OF YOUR TWO CHOSEN REFEREES:

REFEREE 1 (Academic Referee):
NAME:
Ref Name 1:
ADDRESS:
Ref Address 1:
TOWN:	POST CODE:
Ref Town 1:	Ref Postcode 1:
COUNTRY:	TELEPHONE:
Ref Country 1:	Ref Telephone 1:
EMAIL ADDRESS:
Ref Email 1:

REFEREE 2:
NAME:
Ref Name 2:
ADDRESS:
Ref Address 2:
TOWN:	POST CODE:
Ref Town 2:	Ref Postcode 2:
COUNTRY:	TELEPHONE:
Ref Country 2:	Ref Telephone 2:
EMAIL ADDRESS:
Ref Email 2:

Speak Level 2:

Speak Level 1:

Speak Level 3:

Read Level 2:

Read Level 1:

Read Level 3:

Write Level 1:

Write Level 2:

Write Level 3:

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