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SCIENCE
MSc STUDENT APPLICATION FOR
REGISTRATION
Personal Details:
Permanent
Address:
Contact
Telephone
number:
Email Address:
Address for
correspondence
(If different, to
above -
please give dates)
First language:
Second language
1
UCD student
number
(If applicable)
Qualifications:
Qualification
:
Standard
Obtained:
Awarding
Institute:
Date of
attendance:
Date of
Award:
Standard
Obtained:
Awarding
Institute:
Date of
attendance:
Date of
Award:
MSc research
P/T
2
September
2017
January
2018
May 2018
3
Subject Area of Degree: e.g. Diagnostic imaging; Vascular Biology; Medicine etc.:
Research Proposal:
Title of Project:
Include background to the project and outline the problem to be addressed. Include
research hypothesis, overall aims of the project and methodology to be used.
Outline the novelty and significance of the work proposed.
If your project involves a clinical trial please include details of the clinical design of
the trial and your specific role in the project.
4
SECTION 2 : (To be completed by the principal supervisor*)
*Please read the accompanying explanatory notes before completing this form
E-mail :
UCD PERSONEL
NUMBER :
No. of full time No. student supervised to Permanent member of UCD
students under completion: academic staf
primary Yes No
supervision at If no, please indicate current
present: status:
*Adjunct: Yes No
________________________________
_
E-mail :
E-mail :
5
If more than one other supervisor is involved, please duplicate the above fields.
Please note that other supervisors are required only where their expertise is
required for the students research on an ongoing basis.
E-mail :
Addre I am attaching a letter
ss: of nomination
Yes No
Adviser 2:
Titl First Last
e: name: name:
E-mail :
Source
Amoun
t
Period
YES NO
6
DECLARATION BY PRINCIPAL SUPERVISOR:
Signature
Date
Primary
Supervisor
Signature
Date
Co-
Supervisor
Signature
Date
Additional
Supervisor
Signature
Date
7
REFEREES:
Please enter the names, addresses and status of TWO referees who should be able
to comment on your academic suitability for research.
Referee
Status
Email Address
Referee
Status
Email Address
DECLARATION BY APPLICANT:
I also confirm that I meet the English Language entry requirements for
UCD.
https://myucd.ucd.ie/admissions/english-language-requirement.ezc
Please attach certificates if applicable
NAME
SIGNATURE
DATE
8
SECTION 3: (To be filled out by the SMMS Research office)
RMP (Chair):
Title: Last name: First name:
E-mail :
Biomedical
Research Degree
Committee
Meeting
MPB Meeting
Acceptance
SRI Rec.
RMP
recommendation
Notification