PROGRAMME APPLICATION FORM Master of Science in Pharmaceutical Medicine Next intake: Spring 2013 Please complete this application form with reference to the accompanying Information Sheet SECTION 1: PERSONAL DETAILS Surname (as you wish it to appear on any awards): First Name (as you wish it to appear on any awards): Address for correspondence: Gender: Tel. No (Day): Tel. No (Evening): E-mail address: Date of birth: Country of Birth: SECTION 2: SECOND-LEVEL EDUCATION Type of qualification (Leaving Certificate; A-Level; BTEC) : Name of Secondary School: 1 of 5
SECTION 3: THIRD-LEVEL/OTHER EDUCATION Title of qualification: Title of qualification: Awarding body: Awarding body: Institution attended: Institution attended: Overall grade: (Subject; Grade) Overall grade: (Subject; Grade) Please note we do not accept photocopied transcripts you must include original or certified copy of all third level college transcripts with your application form. Qualifications in languages other than English must be translated. Certified copies are preferable as we cannot return original parchments/documents. SECTION 4: EMPLOYMENT HISTORY Please attach an additional sheet/cv if necessary Please give details of employment background: 2 of 5
SECTION 5: EXEMPTIONS Are you seeking exemptions (based on previous study, qualifications obtained etc.)? YES NO If yes, please give details and include supporting documentation. SECTION 6: HEALTH/DISABILITY/SPECIFIC LEARNING NEED - OPTIONAL Provision of the information in this section is requested only to enable Hibernia College to accommodate your needs and will not prejudice your application. Please state any disability, condition of health or specific learning need which could have a bearing on your studies and which requires the provision of appropriate facilities: Please give details of any facilities that you may require to enable you to participate in your course of study. If none, please state none : Please note, in order for the College to reasonably accommodate individual needs you will be required to provide a report from a consultant or Educational Psychologist as appropriate SECTION 7: ADDITIONAL INFORMATION Please provide a statement outlining any supplementary information (personal achievements, career goals, etc.) that you feel may support your application and explaining why you wish to enrol on this programme 3 of 5
SECTION 8: RECOGNITION OF PRIOR LEARNING Holders of a level 7 Bachelor's Degree can apply for entry to the programme through the recognition of prior learning. The College will assess such applications on an individual basis. Applicants will be required to submit a portfolio of evidence demonstrating their learning and achievement to a level 8 standard. Such applicants must meet all other requirements. Such applications have a longer timeframe for processing and must be received a minimum of 2 months before programme start date. Please tick if you are seeking entry to the programme via recognition of prior learning: SECTION 9: ENGLISH LANGAUGE REQUIREMENT Applicants whose first language is not English, and who are not presenting the subject English in a school-leaving examination which is at least of Leaving Certificate OD3 standard (e.g. GCSE grade C) must present one of the following: The minimum English Language Requirements in relation to TOEFL (Test of English as a Foreign Language) and IELTS (International English Language Testing System) are as below : TOEFL 600 with test of written English at 475 + IELTS 6.5 with a minimum of 6.0 in Academic English Alternatively, any of the following qualifications is acceptable as the minimum English language requirement for entry: CSE Grade 1 Pass in English GCE O Level English Language at Grade C or above. GCSE English Language at Grade C or above. Hong Kong Certificate in Education: English Language Syllabus B, Grade C or above. Irish Leaving Certificate English at Grade D3 Ordinary Level or above. Joint Matriculation Board (JMB): Test in English (Overseas) examination Pass. University of Cambridge ESOL Examinations: o Proficiency: Minimum Grade C; o Advanced: Minimum Grade B. Other evidence of proficiency in English may be accepted. Advice may be obtained from the Office for Academic Affairs by emailing academicaffairs@hiberniacollege.net. For all proficiency tests the results must be less than 2 years old. Please indicate details of how you meet this requirement, applicants must also send supporting document as evidence of this : 4 of 5
SECTION 10: FEE PAYMENT - COST OF PROGRAMME If paid in full before the commencement of the course the tuition fee is 18,000, payable in Euro. If paid in two annual instalments the course fee is 19,200 (i.e. 2 annual payments of 9,600). A non-refundable deposit of 960 must be paid to the College on successful admission in order to secure your place. The remainder of course fees must be paid no less than 10 working days prior to the course commencement date. If you decide to pay over two years the first payment of 8,640 (i.e. 9,600-960 deposit) must be made no less than 10 working days prior to the course commencement date. The second payment of 9,600 must be paid at the start of your second year. SECTION 11: CHECKLIST Prior to returning your application form please ensure you: Have fully completed all sections of the application form Have included a transcript of all third level results (original or certified copy - photocopied transcripts are not accepted see note 1a) confirming that you hold a primary degree (National Framework of Qualifications Level 8*). This must confirm the level of award that you received (e.g. First Class Honours, Second Class Honours Level 1, etc.) * Please see Entry Requirements on p. 4 for further details on holders of a primary degree NFQ level 7 Please do note we cannot return original parchments so please send certified copies Transcroipts should be translated if not in English Did you attend a webinar with Hibernia College? YES / NO Did you attend a Hibernia College Open Day/Evening event? YES/NO Applicants should only apply when they have all the information required. Incomplete applications will be deemed unsuccessful. I formally apply to Hibernia College for a position on the course as stated above. All the above information I have given is correct, to the best of my knowledge. Signed Date Please return your completed application form to The Admissions Office, Hibernia College, 2 Clare Street, Dublin 2, Ireland Or email to: academicaffairs@hiberniacollege.net 5 of 5