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 jackie.eales@canterbury.ac.uk 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 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) Page of 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 Page of End date In presenting your case, you should consider the following points: 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 Page of