Application Form The Henley Full-time MBA Your best possible outcome For office use only Date received Admissions Officer Interview Thank you for considering the Henley Full-time MBA. Before completing your application form, we strongly recommend that you read the accompanying notes thoroughly, as an incomplete application may result in delays. Simply complete every section of your form and email it to us, along with all supporting documents required (please see Application Form Notes), to admissions@henley.com Section 1 To start 1.1 When do you intend to begin your MBA? Month and year 1.2 Have you ever applied for, or completed, another programme at Henley Yes No 1.3 If yes, please provide details: Section 2 About you 2.1 Title (Mr/Mrs/Ms/Miss/other) 2.2 Family name 2.3 Forenames (in full) 2.4 Preferred name 2.5 Sex (male/female) 2.6 Date of birth (dd/mm/yyyy) 2.7 Ethnicity Section 3 Staying in the UK 3.1 Nationality 3.2 Country of permanent residence Application Form The Henley FT MBA 01/13 Page 1
3.3 Have you ever been resident in the UK before? Yes No 3.4 If yes, please give the dates for when you were most recently resident in the UK; the length of time you were here and the reason for your visit: Section 4 Your contact details 4.1 Home address 4.2 Country 4.3 Post/zip code 4.4 Telephone, including international code 4.5 Mobile 4.6 Email Section 5 Your current job 5.1 Present job title 5.2 Date appointed 5.3 Employer 5.4 Address 5.5 Telephone 5.6 Email 5.7 What type of business activity is your employer involved in (e.g. finance, technology, manufacturing)? 5.8 Gross annual salary ( ) (please note: your salary will not affect your eligibility. This information is used for rankings surveys and research purposes) Section 6 Your role and achievements Application Form The Henley FT MBA 01/13 Page 2
6.1 Please tell us more about your current duties and responsibilities 6.2 What do you believe to be your greatest achievements in this role? Please give as many examples as you think would be relevant. Giving one achievement is also perfectly acceptable. Section 7 About your work experience 7.1 Since you graduated, how many years have you worked in a professional capacity? 7.2 How many years total work experience do you have? Section 8 More about your work experience For us to assess properly your application, we need to get a clear and detailed understanding of your work experience since graduating. Please answer the following questions as accurately as possible, with examples. If you have held more than one position during the last five years, please answer for each job you have held, starting with your current role, for each criterion listed. Criterion a) How autonomous are you, or have you been, in your stated jobs? Do you have to manage yourself? How are you motivated? What are your KPIs? Years experience Summary Statement b) Does, or has, your job required specific professional, technical or expert knowledge? c) Does/did your jobs require you to think for yourself, make original contributions or find innovative solutions? Have you been required to be creative in any way? d) Are you, or have you been, expected to contribute to decision-making processes in your role? What kind of decisions? Were they business-critical decisions or day-today? e) Are you, or have you been, responsible for managing specific projects or teams within an organisation. Please tell us the Application Form The Henley FT MBA 01/13 Page 3
size and nature of the tasks and people you have managed. f) Are you responsible for managing or working with budgets? g) Please tell us how you have progressed in your career in terms of responsibility, whether technical, managerial or creatively. Section 9 About your education Please tell us about your academic qualifications, starting with the most recent. Qualification Class or grade Subjects University or college Dates of course Graduation date Please indicate the highest academic qualification you have achieved Section 10 About your professional qualifications Name & address of institution Qualification and course Year awarded Associate / fellow / member Application Form The Henley FT MBA 01/13 Page 4
Name & address of institution Qualification and course Year awarded Associate / fellow / member Section 11 Your personal statement This is your chance to really convey who you are and what you believe you can bring to the Henley MBA. Be honest about your strengths and weaknesses. Tell us your aspirations what you want to get out of your career and life. Write between 600-700 words. Please continue on an extra page if required (the box will expand if you re completing this form online). Application Form The Henley FT MBA 01/13 Page 5
Section 12 Your references Please provide the names and contact details of two referees. You can choose either one business reference and one academic reference or two business references: Referee 1 Name Position Address Telephone Email Referee 2 Name Position Address Telephone Email Section 13 Your details 13.1 Please tell us which address you would like us to use for each of the following: a) Correspondence b) Course materials c) Email Home Home Home Work Work Work Please note: work address is preferable for course materials as a signature is required on delivery. 13.2 Has your employer given support to this application? Yes No 13.3 Please indicate who will be responsible for your fees: Yourself Your company Shared 13.4 Percentage split (if shared): You % Your company % 13.5 Would you like us to invoice your company? Yes No 13.6 Company contact name and address for invoice (if applicable) 13.7 Purchase order number (if required) Application Form The Henley FT MBA 01/13 Page 6
Section 14 For international applicants 14.1 Is English your first language? Yes No 14.2 If no, please provide details of all English language tests taken, along with the date the test(s) were taken and the scores you obtained. 14.3 Please tell us if any previous degree you have taken was taught in English. Section 15 For applicants with disabilities If you have a disability that may affect your experience, please provide details: Do you have a disability? Yes No If yes, what is the nature of your disability? Further details of disability if required Blind / partially-sighted Wheelchair user / mobility difficulties Mental health difficulties Autistic Spectrum Disorder Multiple disabilities. Specify below. Deaf / hearing impairment Personal care support Unseen disability, e.g. diabetes, epilepsy, asthma A learning difficulty, e.g. dyslexia A disability not listed above. Specify below. Section 16 How did you hear about us? 16.1 We would like to send you information about other Henley Business School and University of Reading activities and programmes. Please indicate whether you are happy to receive such information: Yes No 16.2 Please indicate the main source of information which prompted you to apply for the Henley MBA programme: Recommended by current/former Henley student Recommended by company contact An MBA Fair. Location: Advertisement. Where: AMBA/AMBA Guide Which MBA Guide Henley Business School website Agents MBA listings Heard about us in the press or through rankings Heard about us online or through social media Other. Please state: 16.3 Have you met or been contacted by our MBA team, been to an MBA open day or been involved in out webinars? Yes No 16.4 If yes, what was the location of the seminar? At Henley In London Other location (please state where): Application Form The Henley FT MBA 01/13 Page 7
Section 17 Your declaration I have enclosed all the relevant documents requested in the application checklist (overleaf) Tick box I have not enclosed all the relevant documents as some are being verified. The documents that are missing are (please list): The personal information you provide on this application form will be used by the University of Reading to process your application, and this includes making a decision on whether to offer you a place. Your personal information will be held securely according to the University s data protection policy, which can be seen at www.reading.ac.uk/internal/imps/dataprotection If any of the information on your application form is found to be false, it may lead to the withdrawal of your place at the Henley Business School, part of the University of Reading. I declare that all the information I have supplied is true and that no information has been omitted that could affect my application. Name of applicant Date I agree for this application form to be submitted to admissions at the University of Reading Yes No The University may also send you further details about its events, activities and programmes, and it sometimes uses third parties to mail these materials. If you would prefer not to receive this sort of information or would not like your personal data used in this way please tick here Thank you very much for your time and investment taken in completing your application form. We will let you know as soon we can if we have any further questions. In the meantime we estimate it will take around 21 days for our admissions and MBA senior faculty to carry out a rigorous exercise in considering your application and ensuring that we have taken everything into account before we let you know our outcome. We wish you all the best. Application Form The Henley FT MBA 01/13 Page 8
Application checklist The Henley MBA Please complete this application checklist to remind you which documents should be enclosed with your application. If any of the documents requested are missing, there may be a delay in the processing of your application. Copy of application form Certified copies of certificates Please also include English translation, if applicable. Full transcript of degree programmes taken to date Please also include English translation, if applicable. English language certificate For example, IELTS, TOEFL, (if required) Or will be sent by (dd/mm/yyyy) Completed section 7 (Management experience) One completed section for each role held over last five years Current curriculum vitae Reference one Or will be sent by (dd/mm/yyyy) Reference two Or will be sent by (dd/mm/yyyy) Application Form The Henley FT MBA 01/13 Page 9