Cranfield Executive Doctorate (DBA) Programme. Application Fee

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1 Cranfield Executive Doctorate (DBA) Programme Application Fee All application forms for the Executive Doctorate Programme must be accompanied by a (VAT inclusive) Application Fee. Cheques should be made payable to Cranfield University, or you may pay by Visa/Mastercard. Please print your details on the tear-off slip below. We are unable to process applications received without this covering payment. VAT Reg:- GB Executive Doctorate Application Fee Name I enclose cheque made payable to Cranfield University Or Debit my Visa. Mastercard... Credit Card Number For security, please the 3 Digit Security Code to: Cardholder s Signature.. Name & Address of Cardholder... Post Code. Expiry Date. 1

2 Please type or write clearly in black ink All data held by the University will be treated as confidential and will only be processed for purposes connected with your studies, or your health & safety while on the University s premises, or for other legitimate reasons such as the compilation of statistics by UK government funding bodies, HESA. All data is kept and processed in accordance with current Data Protection Legislation. Student Number:.. Executive Doctorate (DBA) Programme Application Form Please complete all parts A F, including the Application Fee Form 1. Executive Doctorate commencing I hereby apply for admission to the Executive Doctorate Programme. The information given in this form is correct. If accepted as a student I will comply with all the regulations, conditions and rules made by the University. Signed... Dated Personal Details Family Name... First Name(s)... Title (Mr, Mrs, Dr, etc)... Male/Female... Nationality.. Country of Permanent residence... Date of Birth (dd/mm/yyyy)... Passport Number... Passport Issuer... 1st Address Enter your present address for correspondence here: 2nd Address If you plan to move you should enter your new address (if known) here: Postcode Postcode... Date until... Date from... Daytime Tel No... Daytime Tel No... Home Tel No... Home Tel No... Fax No... Fax No Proposed Research Issue: Please return the completed form to: Barbara Birtles (Mrs), Research Office, Cranfield School of Management, Cranfield, Bedford, MK43 0AL Tel: +44 (0) Fax: +44 (0)

3 Part A - Your Education 1. Secondary School Education (age 16+ studies only) List achievements in reverse date order. Dates attended (mm/yyyymm/yyyy) FT/ PT School, university, college/ country of residence during studies Subject Qualification achieved Results Achieved* Language of instruction * Rank in class, class of degree, GPA, etc. 2. Higher Education (First degree and above) List achievements in reverse date order. NB. Admission to the Executive Doctorate is dependent on the applicant holding an MBA or equivalent Masters Degree with significant management content. Dates (m/y m/y) FT/ PT Name of Awarding Institution Degree Title (inl. Subject studied) Qualification and grades achieved* Language of instruction Country of residence during studies 3. Professional Qualifications Dates Professional Body Main Subjects Covered Qualification Gained Full or part time 4. English fluency Fluency in English is a requirement for entry to the programme. If English is not your first language or you have not been using it on a daily basis during the last five years you may be asked to take the IELTS or TOEFL tests. If you have any doubts about whether you should take these tests, you should contact the Research Office at Cranfield who will be happy to advise you. Is English your first language? YES/NO If not English what is your first language? How long have you been speaking English and in what connection do you use it? IELTS score.... (Minimum Band 7 overall and minimum writing score of 6.0) * Essential Information 3

4 5. Prizes, Awards or Scholarships Gained 4. Reasons for non-completion of any courses which you entered Part B Employment History 1. Career Summary (current or most recent post first) Dates From m/y Dates To m/y Employer Location Job Title Final Salary 2. Duties and responsibilities of your present or most recent post. Please describe your current duties, responsibilities and position in your organisation as clearly as possible so that we may understand the depth of your experience and the contribution you can make to the Executive Doctorate Programme. If you have been in your present job for less than 6 months you should also include details of your previous job. If applicable, include how many staff are responsible to you, your budgetary responsibilities and the position of the person you report to. Nature of Employer s business (principal products and/or services): Duties and responsibilities: 4

5 Part C - You as a person 1. Please outline your career and personal objectives and how the Executive Doctorate will help you to achieve them. 2. Have you undertaken any forms of research? Please give details and explain what you gained from this experience. 3. What is the management issue on which you plan to focus your Executive Doctorate? 5

6 a) Why do you think this issue is an important topic and why does it need researching? b) What questions do you think your research might address? c) What might be understood or known as a result of your research? d) To whom would it be of value? Part D - Other Details 6

7 1. To which other business schools are you applying? 2. Other activities - give details of your hobbies, sporting activities and other outside interests, for example work in the community. 3. Financial Position 1. Are you able personally to pay the cost of attending the course? YES/NO 2. Are you to be financially supported by your present employer? YES/NO If yes state to what extent... Sponsoring Employer Name and Address Referees You should nominate two referees. One should be an academic who can vouch for your performance on your degree. The other should be someone who can comment on your performance in a recent employment. It need not be your current employer. The Cranfield system requires you to send your referees the enclosed Confidential Reference Forms and pre-addressed envelopes. Please remember that it is your responsibility to obtain references and if necessary to remind your referees. Name Organisation Position Academic Address Work Tel No: Address Tel No: 5. Identify why and how you believe your organisation will support your Executive Doctorate research and what problems you may foresee in the process. 7

8 Part E 2. Employment Position 8

9 Applicants in full-time employment during this programme should obtain the agreement of their employer. YES NO 1. Have you discussed your application with your employer 2. Are they agreeable to releasing you for attendance at Cranfield on the specified dates? 3. Are they prepared to provide you with financial assistance to meet the costs of the programme? 4. Are they prepared to provide you with facilities to undertake research during the programme? 5. Name and Address of Employer Postcode... Tel No... Fax No Name and job title of contact with your Company Source of Information How did you hear about the Cranfield Executive Doctorate? If ticking more than one box, please indicate the first source of information. Please specify. Web search engine (e.g. Google)... Course listing website... External website... Journal article/newspaper... CU Directory/Prospectus... External publication... Recommendation by current student... Recommendation by employer... Prior contact with Cranfield... CU Alumni... Other Directory... Other... Part F 1. Equal Opportunities 9

10 Cranfield University is committed to a policy of equal opportunity for all its students. Monitoring the composition of the student body will help the University to take steps to ensure that it does not discriminate. The classification used is in accordance with that used in the UK census. Ethnic Origin I would describe my ethnic origin as (please tick box): White British 11 Asian or Asian British - Bangladeshi 33 White - Irish 12 Chinese / other Ethnic background Chinese 34 Other White background 19 Other Asian background 39 Black or Black British - Caribbean 21 Mixed White and Black Caribbean 41 Black or Black British - African 22 Mixed White and Black African 42 Other Black background 29 Mixed White and Asian 43 Asian or Asian British Indian 31 Other Mixed background 49 Asian or Asian British Pakistani 32 Other Ethnic background (please specify) Disability Please the box which best describes your status with respect to any disability: No known disability 00 Dyslexia 01 Blind/partially sighted 02 Deaf/hearing impairment 03 Wheelchair user/mobility difficulties 04 Personal care support 05 Mental health difficulties 06 Unseen disability, e.g. Multiple disabilities 08 Diabetes, Epilepsy, Asthma 07 A disability not listed above 09 Is your disability registered Yes 02 No 03 10

11 CONFIDENTIAL REFERENCE FORM THE CRANFIELD EXECUTIVE DOCTORATE (DBA) PROGRAMME When you have completed this form please return it in the enclosed pre-addressed envelope. Alternatively Post to: Barbara Birtles, Executive Doctorate (DBA) Programme Manager, Cranfield School of Management, Cranfield University, Cranfield, Bedford, MK43 0AL, England. or a pdf: Signed pdf forms will be accepted. If not signed, please follow up with a signed copy. Your help in dealing with this reference promptly will be greatly appreciated. We will not normally invite the applicant to interview until we have received this reference form. To the Applicant (please print) Family Name... First Name(s)... Proposed start date... Please send this form and the pre-addressed envelope to your referee. To the Referee The person named above is applying for admission to the Executive Doctorate programme at Cranfield School of Management and we would appreciate your help in assessing the suitability of the applicant for this course. Information supplied by referees provides an important input into the admission process. The Cranfield Executive Doctorate is a 4 year, part-time research-based degree which is driven by a management issue. The programme is aimed at experienced practitioners and gives them the opportunity to stand back from their current situation and reflect on a critical issue. Please comment on the applicant s suitability to undertake such studies. Name of referee... Organisation... Position... How long have you known the applicant (years)?... When did you last have regular contact with the applicant (years)?... Describe the capacity in which you knew the applicant... Is the applicant still with your organisation? YES/NO If not, when did he/she leave?... Please detail any personal circumstances which might affect the applicant s performance on an intensive and demanding programme. 11

12 Describe the applicant s strengths and weaknesses. Please comment on any task, project or other situation in which the applicant has been involved which may demonstrate his or her potential. Please rank the applicant on the following scales where 1 is below average and 5 is above average. Low Average High Not Known 6 Ability to analyse and evaluate ideas Perseverance and motivation Emotional maturity and stability Written communications Ability to work with others Ability to reflect and learn from experience Overall assessment Finally. Please comment on the rankings which you have given and on any other factors which you believe should be drawn to the attention of the Admissions Committee in assessing the suitability of this candidate for our programme. Signed... Dated... THANK YOU FOR GIVING YOUR TIME TO COMPLETE THIS REFERENCE FORM 12

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