1 APPLICATION FOR GRADUATE STUDIES SECTION A – PERSONAL DETAILS Please attach a passport-sized photograph here on completed printed form Surname/Family Name: Other Names (in full): Title (e.g. Dr/Mr/Ms): Date of Birth: Gender (Male/Female ): Country of Birth: Nationality: Passport No: Please enclose copy Permanent Home Address: Correspondence Address (if different): From Date: To Date: Contact Home Telephone No: Mobile: Contact e-mail: Residential Information Have you lived in the UK/EU continuously, with the exception of holiday periods, since birth? YES NO If YES go to Section B, if NO please answer the two questions below:
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APPLICATION FOR GRADUATE STUDIES
SECTION A – PERSONAL DETAILS
Please attach a passport-sized photograph here on completed printed form
Surname/Family Name: Other Names (in full):
Title (e.g. Dr/Mr/Ms): Date of Birth: Gender (Male/Female): Country of Birth: Nationality:
Passport No:
Please enclose copy
Permanent Home Address: Correspondence Address (if different):
From Date:
To Date:
Contact Home Telephone
No: Mobile: Contact e-mail:
Residential Information
Have you lived in the UK/EU continuously, with the exception of holiday periods, since birth? YES NO
If YES go to Section B, if NO please answer the two questions below:
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If NO, please state precisely where you have been resident during the last 10 years (including periods spent in
further/higher education):
Is there any restriction on your eligibility to reside / work in the United Kingdom? YES NO
If the answer is YES, please specify such restrictions:
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SECTION B – COURSE OF STUDY DETAILS
Do you wish to study FULL-TIME or PART-TIME? (tick appropriate box) If you wish to study full time an Interview
be arranged.
Proposed month and year of entry:
Please indicate which course of study you would like to be considered:
MA in Practical Theology
MA in Biblical Studies
MA in Missional Leadership
DMin
MPhil
PhD
During the period of your proposed study, will you be registered simultaneously for any other Higher Education
qualification? YES NO If YES, please give details:
Have you studied with Mattersey Hall previously? If so please state on which course and dates of study.
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SECTION C – EDUCATION AND CAREER
You should indicate here details of all higher education, academic and professional qualifications achieved/expected (please
put official title of award) with the most recent first. Please attach photocopies of official transcripts and certificates
University/Institution attended
(with dates)
Title of Degree
or Qualification
Main Subject Classification
or Grade
Date of Award
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Details of Relevant Employment
Employer Period of Employment Main Duties
SECTION D – FINANCIAL SUPPORT
Please state how you intend to finance your studies (e.g., sponsorship, self-finance):
If a third party will be financing your studies (e.g. scholarship, employer, sponsor, research council) please provide us
with official written confirmation of this directly from the third party involved. Please also be aware that if, for any
reason, the third party withdraws its funding, you will be liable to meet all the costs of the course yourself.
I am aware of the costs involved in financing my studies and I accept that any fees that are due and payable
to Mattersey Hall, howsoever incurred, remain my sole responsibility for payment.
Do you have any criminal convictions (excluding motoring offences for which a fine and/or up to three penalty
points were imposed)? YES NO
Ethnic Origin
This section is for applicants resident in England, Wales, Scotland, Northern Ireland, Channel Islands or the
Isle of Man ONLY. This information is collected for statistical purposes only. Please place an X in the relevant box.
I would describe my ethnic origin as:
11 White British 22 Black or British African 41 Mixed White & Black
Caribbean
12 White Irish 29 Other Black Background 42 Mixed White & Black African
13 W hite Scottish 31 Asian or British Indian 43 Mixed White & Asian
14 Irish Traveller 32 Asian or British Pakistani 49 Other mixed background
15 W hite Welsh 33 Asian or British
Bangladeshi
80 Other ethnic background
19 Other White Background 34 Chinese
21 Black or British Caribbean 39 Other Asian Background
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Health and Diet
Do you have any medical condition or special need? YES NO
If YES please place an X in the appropriate box(es) below:
Dyslexia Blind/Partially Sighted Deaf/Hard of Hearing
Wheelchair User/Mobility Difficulties Personal Care/Support Mental Health Difficulties
Unseen disability (e.g. diabetes,
asthma)
Other (please specify):
Do you have any special dietary requirements? If so, please specify here:
SECTION F – ENGLISH LANGUAGE ABILITY
Is your first language English? YES NO
If NO, please indicate your proficiency in English by placing a X in the relevant boxes below:
Excellent Good Fair Poor
Writing (Academic)
Listening
Comprehension
Speaking
Reading (Academic)
Please supply IELTS and TOEFL scores and transcripts if English is not your first language or state which exams you
have passed in the English Language.
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SECTION G – CHURCH AND MINISTRY BACKGROUND
To what church do you belong?
How long have you attended there? __
What is the church’s denominational affiliation (if any)?
What ongoing involvement have you had in the life of this church and/or any other Christian organisation?
Please attach to this application a brief account of your Christian experience, on up to two sides of A4 paper. This
should include your conversion, baptism, experience of the work of the Holy Spirit, etc., including dates if possible,
and should explain why you are applying to Mattersey Hall, and, if possible, what sphere of Christian service you
anticipate entering.
REFERENCES
We require both a pastoral and an academic reference for all applicants. To facilitate this, please
complete the grey boxes on the following two reference forms and pass them to your referees. Your
pastoral referee should ordinarily be the minister of the church you regularly attend, and the
academic referee should be someone who is able to comment on your study skills and academic
ability – ideally a teacher or lecturer.
The referees should return the form to you in sealed envelopes and they should sign over the seal
for security and privacy . Do not open the envelopes but send them, along with:
• This application form (including the account of your Christian experience), a copy
of your passport and a copy of certificates and transcripts.
• Payment of application fee (£15.00 cheques made payable in sterling to Mattersey Hall). This can be paid by card by phoning the Mattersey Hall finance department on 01777 817 663. Bank transfers can be made to the following account (please ensure that you put your name as the reference and email admissions to let them know that you have paid) Assemblies of God Bible College, Barclays Bank, Sort Code: 20-55-62, Account: 60126047.
• A passport size photograph with your name clearly printed on the back if sent by
post :
Please email this form, including a photograph of yourself to: [email protected] or
send to: Admissions, Mattersey Hall, Retford Road, Mattersey, DN10 5HD, England, UK
You can ordinarily expect to hear from us within 28 days from receipt of your
completed application. We will not be able to process incomplete applications, so
please ensure you have enclosed everything we need.
