Dialogues on Disability | Application Form

Please read the information about the initiative and FAQs before you complete the application form. If you prefer not to submit written answers to the supporting statements, please complete the applicant details form and then submit a video or podcast of your answers to the questions without exceeding the word count.

Dialogues on Disability: Berlin 2018

All applications must be submitted by 10.00am on Friday 4th May 2018. Please refer to the King’s website for further information relating to the programme and eligibility criteria.

If you have particular support needs and would like to discuss whether these can be supported by the host Institution before you begin the application process, please contact disability@kcl.ac.uk

Applicants Details

Full name

Student ID number (this is not your K number)Contact address

Email address

Mobile telephone text or call

I am currently enrolled on a degree programme at King’s (Tick box)

I have a disability, long term medical or mental health condition or Specific Learning Difficulty (Tick Box)

Degree title

Year of study

Do you hold a valid passport that has at least two blank pages in it and will remain valid for at least 180 days from the date of departure?

Yes / No

www.kcl.ac.uk

Selection Criteria

Students will be judged against the following selection criteria:

Interest and engagement in disability inclusion Cultural sensitivity and curiosity Character and ambassadorial qualities Transformational effect (I.e. how will the programme impact your learning and confidence?)

Engagement and leadership

The selection panel will be made up of members of the Disability Advisory Service, King’s Worldwide and KCLSU.

Supporting StatementsPlease tell us why you are interested in the Dialogues on Disability Programme and how you think you would benefit from the experience? (please describe in less than 300 words)

Using one or more examples, please describe your engagement with disability inclusion, giving an example to illustrate your engagement. (please describe in less than 300 words)

What do you think makes a good ambassador? (please describe in less than 300 words)

Please explain why you think discussing disability through different cultural lenses is important? (please describe in less than 300 words)

I confirm that I am available for interview on either the 17th & 18th May 2018. Further that I will be available to participate in the programme on the Sunday 26th August - Sunday 2nd September and that I am able to travel.

Name Date

Please return this form and your Equality and Diversity Monitoring form either by email to: studyabroad@kcl.ac.uk or deliver in person to Global Mobility, King’s Worldwide, K0.60, King’s Building, Strand Campus.

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Selection Process

Stage 1: Successful applicants will be notified on Friday 11th May 2018

Please Note: If successful at Stage 1 you will be invited to interview and should be available on 17th & 18th May. If you require any support in completing your application, please contact disability@kcl.ac.uk.

Please note: Information provided on this form will be used to assess the eligibility of the applicant for the programme. Information provided will be used by the selection panel to shortlist applicants for interview.

Successful applicants will be required to provide evidence of their disability, long term medical or mental health condition or specific learning difficulty in order to take part in the programme. This is to ensure that the staff supporting the programme are fully aware of the impact your disability may have on your engagement. They will discuss any support requirements to aid participation you may have and liaise with the host institution to ensure your specific needs are able to be met, before confirming your place. If you would like to discuss possible support needs before you complete the application process, please email disability@kcl.ac.uk.

www.kcl.ac.uk