application for admission to the：入学申请

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1、ApplicationforAdmissiontotheLoughborough–ChinaPartnershipProgrammePleasecompleteinENGLISHusingBLOCKCAPITALS.Pleasereturnyourapplicationto:UpulWijayantha,DepartmentofChemistryLoughboroughUniversity,Loughborough,Leicestershire.LE113TUTitle(Mr/Miss/Mrs)ForenamesFamilyNameDateofbirthGenderoMaleoFemal

2、eNationalityPermanentAddress:Tel.No.E-mailCorrespondenceAddress:(ifdifferent)Tel.No.E-mailProposedProgramme:Loughborough–ChinaPartnershipProgrammeDepartmentof:CHEMISTRYFulltime:(Yes/No)YesStartDate:………………………………DurationofProgramme:2YearsCriminalConviction:oNooYesEducation/Professionalqualification

3、s:GivedetailsofyourUndergraduatestudiestodate.Department:University:YearGradeor%SubjectDate1st2nd3rdNote:Pleaseattachatranscriptoftheaboveacademicrecord.Awards:Givedetailsofanyawards,scholarshipsetc.EnglishLanguagequalification:IELTSTRFNumber:………………………………………….OverallScore:………………Listening:………………Re

4、ading:………………Writing:………………Speaking:………………TOEFLRegistrationNumber:………………………………….OverallScore:………………Listening:………………Reading:………………Writing:………………Speaking:………………SpecialNeeds:Pleaseoutlineanyspecialneedssupportyoumayrequireinordertofullyundertakeyourstudiesasaconsequenceofanydisabilityormedicalconditi

5、on.Financialsupport:Whatwillbeyourfinancialsupport?a)Besupportedbyyourself/parentsob)besupportedbyyouremployer/sponsoroIfitis(b),pleasegivethenameandaddressofthepersonorbodyresponsibleforpaymentofyourfees:References:Givethenameandaddressandpositionofonepersonwhocanverifyyouracademicqualification

6、sandhasknowledgeofyourabilitytoundertaketheproposedstudy.Name:Address:Position:Email:Personalstatement:Giveabriefstatementofyourcurrentinterests,thereasonsyouareinterestedinstudyingtheproposedprogramme,whyyounowwishtocontinueyoureducationatLoughboroughUniversityandyourfuturecareeraspirations.Decl

7、aration:Iconfirmthattheaboveinformationiscorrecttothebestofmyknowledge.Signed:…………………………………………………………….Date:…………………………………..TobecompletedbythereceivingDepartmentatLoughboroughUniversityUniversityDecisionProgramme:Loughbo