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PostgraduateApplication Form1 REGISTRATION SOUGHT
niversity of East Anglia
(a)Taug ht M aster s deg ree (classroo m/lab b ased): _M.SC (HONS) _ (e.g. MA History , MSc Environmental Science ZOOLOGY______________________________________________________ , Graduate Diploma Economics or PG Dip Health Sciences ) (b)Research p rog ram m e: ______PH.D (e.g. MA, MSc or MMus byPROGRAMMES_________________________________________________________________________ Research, MPhil or PhD programmes, e.g. PhD Business Management ) Re search sub ject area/to pic o f stud y:______ STUDY OF BIO_ECOLOGICAL STATUS, MANAGEMENT AND CONSERVATION OF CROCODILES (CROCODYLUS PALUSTRIS) IN (e.g. Supply Chain Management ) SINDH_PAKISTAN.__________________________________________________ _________ (c )Sch ool of Stud y / Institute (if known): __BIOLOGICAL SCIENCE________________________________________________________________ (d)M od e of Stud y: _ Full- tim e _ Part-tim e (not available to non-EU applicants) (e)Yea r o f Entry: (f)M o nth of Entry:
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2007 Sep /Oc t
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2008 Jan/Feb
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200 9 Apr
_
Ju l
(Note: most Taught Master s programmes commence in September or October only)
PERSONAL DETAILS(a)Title: (b)Fam ily Name: (c )Given Na m e(s): (d)Gen der: (e)Date of Birth:
2 _MR
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M rs
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M iss
_
Ms
___CHANG________________________________________________________________________________ ___ ________MUHAMMAD SALEEM_____________________________________________________________________________ _ M al e _ Fem ale
__21___ /__01___ /__1980__ (Please complete in the format DD/MM/YY) _ (f)Co untry of Birth: ____PAKISTAN_____________________________________________________________________________ ___ (g)Cou ntry o f Nationa lity: ___PAKISTANI_________________________________________________________________________ ___ (h)Coun try o f Ord in ary Residen ce: _---------_____________________________________________________________________ (i)Hom e Add ress:H ouse N um b er / Street: __P.O AND VILLAGE GHUNDAN______________________________________________________ __________TALUKA SINJHORO_DISTRICT To w n / City: SANGHAR________________________________________________________ C ou nty / State / Pro vince: ___SINDH________________________________________________ ___ C ou ntry: _______PAKISTAN__________________________Zip Code : __68100______________ Po sta l / __ _ Teleph one (inc country code): __(+92) 333 Fax: ___------2643404________________ ___________________________ Ema il: [email protected] (j)Corresp ond ence Ad dress:House Nu m ber / Street: DEPARTMENT OF ZOOLOGY UNIVERSITY OF SINDH JAMSHORO,,SINDHPAKISTAN_______________________________________________________ To w n / City: ____________JAMSHORO____________________________________________________ ___ C ou nty / State / Pro vince: ___SINDH________________________________________________ ___ C ou ntry: _______PAKISTAN__________________________Zip Code : _71000_______________ Po sta l / __ _ Teleph one (inc country code): ___(+92) 333 Fax: ______-------2643404_______________ ________________________ Ema il: [email protected]
UEA Postgraduate Application Form page 1
QUALI FICATIONS(a)AC ADEM IC QUALIFICATION S (i)Please list your university qualifications by level Dates of Study AUGUST ualificatio nAverage University UNIVERSITY OF SINDH 1999 (MM /YY 1999 To M ajo r Subject o f Study JAMSHORO (Bachelor, aster s, PhD) Grades 3.60 2003 ZOOLOGY Name Ci tyF rom T Jashoro, 1999CGPA M 2003
Q
(ii)Was the languag e o f instruction in English?
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YE
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NO
(b)ENGLISH LANGUAGE QU AL IFICATIONS (i)Is your first langu age Eng lish?
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YES
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NO
If N O, p lease select w hich Eng lish lang uage exam yo u h ave taken (if any) and yo ur m ost recent sco re:
_ _ _ _
TOEFLDate IELTSDate
__NO _____________
Result _______________________________________
Result _______________________________________ ____UNDER PROCESS___________ CAMBRIDGE EXAM SDate ____NO__________ Result _______________________________________ _ OTHERDate ____NO__________ Result _______________________________________ _
EMPLOYMENT HISTORY, PROFESSIONAL AND OTHER REL EVANT EXPERIENC EPle ase sta te yo ur previous or pre se nt e m plo yer, an y p rofessio nal and /or relevant experience an d any unp aid work o r q ualifications relevant to your ap plicatio n: Dates o f Emplo ym ent / Experience (M M/YY) From To
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Po sition HeldName of Emp loye NO
PROFESSIONAL QUALIFICATIONS, PUBLICATIONS, EXPERIENCE IN ADVANCED STUDY, PROFESSIONAL BODY AND REGISTRATION NUM BER
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Ple ase state any pro fessional q ualificatio ns, pu blication s, expe rience in ad vanced stu dy or research and an y o th er p ractical w ork w hich is relevan t. Please also state any me mb ership to a p rofession al bod y, in clud ing reg istration n um ber -------------
UEA Postgraduate Application Form page 2
OTHER APPLICATIONS(1) ___------------____________________________________________ (2) _____________________________________________ __ (3) _____________________________________________ __ (4) _____________________________________________ __
HOW DI D YOU HEAR ABOUT THE PROGRAMM E?Ple ase give d etails
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_ _ _ _
University Pu blicity, e.g . prosp ectu s University Websit Perso nal Recomm endatio n
_ _ _
University Advertiseme nt Recruitm ent Fair British Cou ncil
Member of UEA Staff (Please state who ___--------) ____________________________________________________
FUNDINGPle ase ind icate w hether you intend to ap ply fo r o r a lread y h ave fu nding from any of the following org anisation s:
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_ _ _ _ _ _ _ _ _ _ _ _
Biotechn olog y and Biolog ical Sciences Researc h C ouncil (BBSRC Econom ic and Social Re search Co uncil (ESRC) Engineering and Physical Sc iences Re search Co uncil (EPSRC) Medical Rese arch Co uncil (M RC) Natural Environment Research Co uncil (NERC) Arts and Hum an ities Research Cou ncil (AHRC) Gen era l Social Care Council (GSC C) UEA Stu dentship UEA In terna tional Scholarships Emp loyer Sp onsorship Go vern men t Grant Other (Please state _____________________________________________________ ) __
FEE CATEGORYThe level of tu itio n fee yo u pay de pend s on your fee c ateg ory. Ple ase select w ith an X a state me nt fro m the list below wh ich b est d esc rib es you: Sta te me nt X
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1Yo u are a UK national, or live in the Channel Islands or Isle of M an, o r are the child o f a UK natio nal and have lived in the European Econo mic Area (EEA) for three years, bu t no t just for full-tim e edu cation, o r 2Yo u have Indefinite Leave to Enter or Rem ain in the UK or have the Right of Abo de in the UK and h ave lived in the UK for three years, b ut n ot just for full- tim e educatio n, or 3Yo u are a refugee, o r have bee n g ranted Excep tional Leave to Enter or Rem ain in th e UK follow in g an a pplication for asylum , and you have lived in the UK since sta tus was re cognised o r g ran ted , or you are such a p erso n's husb and, w ife o r child, or 4Yo u are a non -UK EU national o r are the child o f a non- UK EU n ational and h ave lived in the Europ ean Econ om ic Area (EEA) for three years, b ut n ot just for fu ll-tim e educa tion, o r 5Yo u are an EEA n ational, you live in the UK and yo u are a migrant w orker (o r you are suc h a person's hu sb and, wife or c hild ) and you have lived in the EEA for three ye ars, but not just fo r full- tim e ed ucation, or 6Yo u do not fa ll w ithin an y of the categ ories abov e
UEA Postgraduate Application Form page 3
0REFEREESPlease give the na m es an d ad dresses and p ositions of the tw o p erson s that you w ish to use as you r referee s. They shou ld b e a ble to testify to you r ac adem ic ability or rele va nt e xperience and one o f these sho uld be your h ead of de partm ent or em p loyer as ap prop riate. 1 Name : DR. GHULAM SARWAR Position: ASSOCIATE GACHAL_______________________________________ PROFESSOR___________________________________________ Institution or C om pa ny Nam e: _DEPARTMENT OF ZOOLOGY_______________________________________________________________________ Institution or C om pa ny Add ress: DEPARTMENT OF ZOOLOGY, UNIVERSITY OF SINDH JAMSHORO SINDH_PAKISTAN___________________________________________________ Referee Em ail [email protected] __________________ m:
SAYED ISMAIL SHAH Position: ASSISTANT BUKHARI_______________________________________ PROFESSOR___________________________________________ Institution or C om pa ny Nam e: INSTITUTE OF _ ENGLISH_______________________________________________________________________ INSTITUE OF ENGLISH, UNIVERSITY OF SINDHJAMSHORO, Institution or C om pa ny Add ress: SINDH_PAKISTAN.______________________________________________________________________ Referee Em ail:------------
2 Name :
1DISABIL ITI ESThe University welc om es studen ts w ith disabilities a nd strong ly enco urage s yo u to disclose any d isability or m ed ica l cond ition w h ic h may have an im p act on you r p ostgra duate stud ies. Declaring a disability will n ot a ffec t the a cadem ic decision a bou t yo ur a pp lica tion b ut will help us put any in dividu al arrang em ents or facilities in p lac e fo r th e start of the c ou rse a nd ena ble u s to m on itor the effec tiven ess o f o ur equ al op portu nitie s an d diversity policies:
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No disabilit y Deaf/hard of hearing Unseen disability Other disab ility
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Sp ecific learning d ifficulty Wheelcha ir u ser/m ob ility Mu ltiple d isabilities Decline to answ er
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Blin d/partially sig hted Mental health difficu lties Autistic sp ectru m d isorder
2ETHNICITY M ONITORINGPlease select you r eth nic origin. Th e inform ation co llec te d w ill be u sed for m onitorin g purp oses on ly and w ill h elp th e Un iversity to im p lem en t eq ual o pp ortunities and d iversity p olicies. Ethn ic ity d ata w ill not be u se d w he n a sse ssing you r a pplica tion.
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White Black Other Black Carib bean Black African Asian Ind ian
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Asian Pakistan Asian Bang ladeshi Asian Chinese Asian Other White/Black Caribb ean
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White /Black African White and Asian Other M ixed Other Decline To An sw er
3CRIMINAL CONVICTIONSDo yo u have any crim inal c onviction s?
1 _Yes
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NO
4DECL ARATIONI confirm that the inform ation given on this form is true, co m plete and accurate, n o inform ation requested or other m aterial info rmation has b een om itted, an d th at I ha ve com p leted the application myself. I agree tha t I have read the relevant application no tes. I undertake to be boun d by th e terms set out in the application form and ap plication notes and I give co nsent to the University of East Anglia to process the d ata (given b y myself) I have supplied. I accept th at if I do no t fully com p ly w ith th ese req uirem ents the U niversity will h ave the righ t to cancel any app licatio n an d that I shall ha ve no claim ag ainst the University (in relation thereto) with rega rd to this. _________________________ ______0100090000037c00000 002001c000000000004000000 03010800050000000b0200000
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Sign ed
Dat e
_29-082008_____________________________
UEA Postgraduate Application Form page 4