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Application Form for Graduate Study 2015-16Before completing this form, please refer to the Graduate Admissions Application Guide (available at www.graduate.ox.ac.uk/applicationguide). Any errors resulting from failure to do so may delay your application.Please write in BLOCK CAPITALS using black ink. COMPLETE ALL SECTIONS.

Section A: Your Personal Details

FAMILY NAME TITLE (Mr, Mrs, Ms, Miss, Mx1 etc.)

GIVEN NAME SEX: FEMALE MALE

MIDDLE NAME(S) DATE OF BIRTH:     day _ _ / month _ _ / year _ _ _ _

PREFERRED GIVEN NAME

PREVIOUS GIVEN NAME (if applicable)

PREVIOUS FAMILY NAME (if applicable)

Section B: Contact Information

HOME ADDRESS CORRESPONDENCE ADDRESS (if different)

CITY: CITY:

POSTAL/ZIP CODE: POSTAL/ZIP CODE:

1 Mx (Mixter) is a gender-neutral title for those who do not wish to use a gender-specific title or who identify as transgender1 GAO2015

Apply online at www.graduate.ox.ac.uk/apply

COUNTRY: COUNTRY:

EFFECTIVE DATES: From:day _ _ /month _ _ /year _ _ _ _

To: day _ _ /month _ _ /year _ _ _ _

TELEPHONE (if you give more than one, please indicate which is the primary contact number)

TYPE (mobile/cell phone, daytime, evening, etc)

COUNTRY CODE(if outside UK)

AREA CODE NUMBER

PRIMARY EMAIL ADDRESS (this should not be an institutional email address that will expire)

Section C: Nationality and Ordinary residence

COUNTRY OF BIRTH:

COUNTRY OF NATIONALITY: In this section give details of the countries of which you have nationality and give date(s). If you have been a national of that country since birth, use your birth date as the 'From': date. Please do not give an end date unless your nationality of that country has ended. These details may be used to determine your eligibility for University scholarships and/or fee status.

COUNTRY FROM (dd/mm/yyyy) TO (dd/mm/yyyy) PASSPORT NUMBERAND EXPIRY DATE

COUNTRY OF ORDINARY RESIDENCE: This is the country in which you are normally resident, not a country in which you are studying, working or living temporarily. However, in the case of EU nationals who are currently studying in the UK, you should provide details of your UK residence. Please do not give an end date unless you no longer reside in that country. These details may be used to determine your eligibility for University scholarships and/or your fee status.

COUNTRY FROM (dd/mm/yyyy) TO (dd/mm/yyyy)

If you are not a UK or EU Citizen, but you are currently living in the UK, do you have Indefinite Leave to Remain Status (which has been entered into your passport)? If yes, please provide the date it was granted: day _ _ /month _ _ /year _ _ _ _

Section D: Disability/Long Term Health Conditions

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The University is committed to making reasonable adjustments to ensure that students with disabilities including dyslexia, dyspraxia (and other SpLDs), with an Autistic Spectrum disorder, or with long-term mental health difficulties or health conditions are not placed at a substantial disadvantage in their access to services, assessment and teaching. In order to provide study support, relevant departments and colleges of the University may need to share information about your needs. Information will be shared on a need-to-know basis with relevant people such as any academic staff you work with, and any library and support staff. The information provided is also used to monitor rates of participation in Higher Education by particular groups of people, which is a statutory requirement; it does not form part of any assessment of your application. If you wish to discuss this section of the application form, or anything to do with University provision for such needs, please contact the Disability Advisory Service disability@admin.ox.ac.uk or refer to their website http://www.graduate.ox.ac.uk/das.Please enter the code most appropriate to you:

0 I am not disabled1 I have a disability and am in receipt of a UK Student Disability Allowance2 I have a disability and am NOT in receipt of a UK Student Disability Allowance:

If you have indicated that you have a disability, please enter the code in the box from the list of statements below which is most appropriate to you.

1 You have a specific learning difficulty such as dyslexia, dyspraxia or AD(H)D2 You are blind or have a serious visual impairment uncorrected by glasses3 You are deaf or have a serious hearing impairment4 You have a physical impairment or mobility issues, such as difficulty using your arms or using a

wheelchair or crutches5 You have a long standing mental health condition, such as bipolar disorder, schizophrenia or anxiety disorder6 You have a long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy7 You have two or more impairments and/or disabling medical conditions8 You have a disability, impairment or medical condition that is not listed above9 You have a social/communication impairment such as Asperger’s syndrome/other autistic spectrum

disorder

Section E: Nominated AgentsData Protection: The University of Oxford will normally only discuss your application with you. If you wish to nominate a third party with whom we may discuss your application and accept direction on its handling, please provide their details. Please note that a nominated third party will be able to amend or withdraw the application on your behalf.

Name of agent and email address Relationship to you Agent’s date of birth

Section F: Details of Current & Previous Higher Education (degree level or equivalent)

University/Institution attended

Start year Year of completion

Qualification obtained / intended award (e.g. BA, MSc). If your qualification was awarded from a non-UK institution, you do not

need to convert your qualification into the UK

system

Main subject(e.g. Chemistry, English)

Actual/expected result (including grade,

classification, Grade Point Average etc.).

Please indicate the date on which final results will

be available

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If you require a student visa (see www.graduate.ox.ac.uk/visa ), please give details below of any period of study, complete or incomplete, taken in the UK that is not already listed above. Please list start and end dates, course title, level and institution.

University/Institution attended Start year Year of completion

Course Title Level

Have you undertaken degree-level study at any institution, either in the UK or worldwide, which you have not completed, excluding any qualification you are currently studying towards? YES NO

If “Yes”, please provide details of the course and the institution and give an account of the circumstances:

Are you planning to begin, or to continue studying for a degree at any institution, either in the UK or worldwide, at the same time as you would also be studying at Oxford for the programme for which you are now applying? YES NO

If “Yes”, please provide details of the course, including whether it is full-time or part-time, the institution and how you believe it will be possible to pursue both programmes of study at the same time (Note: If you will be studying at another institution at the same time then you can only apply to study for a part-time course at Oxford):

Section G: About Your Language Skills

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Is English your first language? YES NO

If you have a working knowledge of languages other than English (including your native language), please specify, and state whether the level of your competence in Reading, Writing, Speaking and Understanding is Poor, Fair, Good or Excellent:

The following questions are included to assist the University to assess applicable English language test requirements and to comply with the UK Visa and Immigration requirements:Have you completed, or are you completing, a full-time degree-level course entirely taught and assessed in English? YES NO

Have you completed a course under a United Kingdom Tier 4 child visa? YES NO

If you have taken IELTS, TOEFL or Cambridge Certificate tests, please complete section H below. You may be required to demonstrate a particular level of English language proficiency to the University for academic or visa reasons.

Please check the English language requirement for your programme in the specific subject entries in the prospectus (www.ox.ac.uk/graduate).Please see the Application Guide available at www.graduate.ox.ac.uk/apply for full details.

Section H: English Language Proficiency and Other Admissions Test ResultsPlease enter details of any relevant tests that you have taken (i.e. IELTS, TOEFL, Cambridge CPE, Cambridge CAE and GRE) and for which you have the results. English language tests should have been taken within two years of the start of your programme. Please convert any old-style GRE scores (200-800) to new-style ones (130-170)

Test type(e.g. TOEFL, etc.)

Date taken Overall result Constituent scores where given

Section I: Programme of Study (for entry in the academic year commencing October 2014)

You should complete ONE of the following subsections: 1, 2 or 3. This form may only be used to apply for one programme. If you wish to apply for more than one programme you must submit a separate application each time.

1.  Applicants for Research Programmes and taught Master’s in History:

If you wish to apply for a research programme, you should complete this section (Research programmes comprise DPhil, MSc(Res) and Master's programmes in Legal Research and Socio-Legal Research)

5 GAO2015Apply online at www.graduate.ox.ac.uk/apply

(i) State the six-digit course code as given in the Application Guide:

(ii) Confirm which research qualification you intend to work towards:

  MSc by research   MSt Legal Research   MLitt   DPhil

  4-year Radiobiology doctoral programme

Wellcome Trust 4-yearNeuroscience doctoral programme

Cancer Research UK 4-year Medicinal Chemistry for Cancer training programme

(iii) State the Department or Faculty in which you wish to work, and a suggested title for your research proposal here; if you are applying for a modern languages programme, please also indicate your proposed primary language of study:

Department or Faculty:

Proposed field and title of research project:

Proposed Supervisor name(s) (if known):

2.  Applicants for Taught Programmes:

If you wish to apply for a taught degree, you should complete this section.

(i) State the six-digit course code as given in the Application Guide:

(ii) Confirm which taught qualification you intend to work towards:

  MSt   MSc by coursework   MPhil   BPhil   BCL   MJur

  Postgraduate Diploma   Postgraduate Certificate   Diploma   MTh

(iii) Give the title of your course (e.g. ‘Modern History’, ‘Diagnostic Imaging’ etc.); if you are applying for a modern languages programme, please also indicate your proposed primary language of study. If you are applying for an MSt or MPhil in Theology, please select a subject area (www.theology.ox.ac.uk/graduate-admissions/masters-degrees.html ):

3.  Applicants for PGCert & PGDip programmes run by the Department for Continuing Education (OUDCE):

If you wish to apply for a non-matriculated programme with OUDCE, please complete this section.

(i) State the six-digit course code as given in the Application Guide:

(ii) Confirm which qualification you intend to work towards:

Postgraduate Diploma Postgraduate Certificate

(iii) Give the title of your course.

Title of course (e.g. ‘Architectural History’, ‘Mathematical Finance’ etc.):

Other institutions to which you have applied or may apply

Institution Name Location

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Future Career Plans:

Section J: Course Information and College Preference

Part-time study requested (please tick):  Please check if your programme of study supports a part time option by consulting the Application Guide – if it does not, and you request it here, your preference will not be taken into account and you will be considered for full-time study.

Alternative start date (please tick):   Hilary Term (January 2016)   Trinity Term (April 2016)You must check if your programme of study supports enrolment at times other than October 2015 by contacting the department or faculty concerned. If it does not, and you request it here, your preference will not be taken into account and you will be considered for entry in October 2015.

COLLEGE PREFERENCE

Please indicate below whether you have a college preference or whether you wish the University to select a college on your behalf.

Details of which colleges accept which courses may be found on our website at www.graduate.ox.ac.uk/colleges

I have no college preference College preference:

7 GAO2015Apply online at www.graduate.ox.ac.uk/apply

Section K: Additional InformationPlease give dates when you would be unavailable for an interview or visit:

If you are applying for a Master’s degree, do you intend to apply for a research degree afterwards?

  YES   NO   UNSURE

Do you intend to apply for accommodation owned by a college?   YES   NO

Do you intend to apply for accommodation owned by the University?   YES   NO

Number of accompanying adults (excluding self) e.g. partner or spouse:

Sex and dates of birth of any children who will accompany you:

Section L: Proposed Funding ArrangementsPlease indicate below the main sources of funding you are most likely to use to fund your tuition fees, college fees and living expenses, in the event that you are not offered a scholarship from the University. This is purely indicative at this stage and will not affect the assessment of your application in any way. If you are offered a place for graduate study, you will later be asked by your College to provide proof of your funding arrangements for programme and living expenses (see www.graduate.ox.ac.uk/financialdeclaration ). Do not include in this section any University of Oxford scholarships or Departmental studentships.

Please tick if you have not yet made any alternative funding arrangements

Proposed Funding Sources e.g. family, scholarship, etc

(If government funds or foundations, please

specify)

Status Amount of funding per

year (£)(if known)

Period Covered

(e.g. 1 year, 2 years etc.)

Expenses Covered (please specify whether this is University tuition

fee, college fee or living expenses)

  Intend to apply

  Applied for

  Firmly secured

  Intend to apply

  Applied for

  Firmly secured

  Intend to apply

  Applied for

  Firmly secured

  Intend to apply

  Applied for

  Firmly secured

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Departmental Studentship Applications:Please tick if you are applying for an advertised departmental studentship:

Please insert the advertised reference code(s):

Section M: University of Oxford Scholarships

In this section you can apply for those scholarships administered centrally by the University and which require you to indicate that you wish to be considered for any of these scholarships. You must read the relevant online scholarship profile at www.graduate.ox.ac.uk/oxscholarships for full details and to check your eligibility before completing this section. We will also use the information you provided earlier in your application to help determine your eligibility for these scholarships. You must apply for these scholarships by the January deadline used by your programme of study. Late applications will not be accepted. Several scholarships administered centrally by the University do not require a specific application to be made; instead, in such cases, eligible candidates will be considered automatically. Further details can be found within our Application Guide www.graduate.ox.ac.uk/apply, or on relevant online scholarship profiles.

Additional funding opportunities may be available through colleges, departments/divisions: www.graduate.ox.ac.uk/fundingsearchand external funding bodies:www.graduate.ox.ac.uk/externalscholarships

You may need to complete specific additional applications for these funding opportunities; you should check the web pages for individual schemes for further details.

To apply, you need to tick the box(es) below, next to the scholarship(s) that you wish to be considered for. Where a scholarship is marked with a ‘*’, you also need to supply additional supporting material by attaching it in the Supplementary Materials section of this form. For further details of supporting materials required, see the relevant online scholarship profile. If you do not submit a complete application, either by not ticking the box or not providing all required supporting materials by the deadline for applications, you will not normally be considered for the scholarship.

Please note that the University reserves the right to consider any eligible candidates for Oxford scholarships.

 Commonwealth Shared Scholarship Scheme Dulverton Hill Foundation Islamic Development Bank Scholarship Jenkins Memorial Mica and Ahmet Ertegun Postgraduate Scholarships in the Humanities* Noon Foundation*

 Open Society Foundations Oxford Scholarships* Oxford Australia Scholarship fund* Oxford Centre for Islamic Studies* Raffy Manoukian Saϊd Foundation Oxford Scholarships Louis Dreyfus-Weidenfeld Scholarships Scheme* Weidenfeld-Hoffmann Scholarships Scheme* Weidenfeld-Roland Berger Scholarships Scheme*

IMPORTANT NOTE

We will often try to link scholarships with additional funds from a specific college, in order to maximise the number of scholarships we can award. If you are successful in obtaining a scholarship, we may need to move your application to a college which is not your preferred college (if you indicated one).

If you do NOT wish to have your college preference changed, please tick this box:

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Section N: Supporting Materials ChecklistSupporting materials are required with all applications.

Check the Application Guide (available at www.ox.ac.uk/graduate/apply ) very carefully to ensure that you understand which supplementary materials must accompany your application. You must send all supporting materials by the deadline for your programme. Any delay in sending the correct materials to the Graduate Admissions Office will most probably result in your application not being considered.

If you encounter difficulty in gathering the materials in time for the deadline, please contact the Graduate Admissions Office graduate.admissions@admin.ox.ac.uk for advice. We may be able to suggest ways to help you meet our requirements, but only if you contact us well in advance of the application deadline.

COMPULSORY FOR ALL PROGRAMMES OF STUDY: Enclosed(please tick)

Official Transcript/s (refer to www.graduate.ox.ac.uk/apply ) An OFFICIAL transcript is a mandatory document for all applications. The copy you provide should be clear and easily readable, but may show watermarks caused by copying/scanning. If your institution provides electronic transcripts, please register access for graduate.admissions@admin.ox.ac.uk and make it available for as long as possible. It is not sufficient to submit a degree certificate or an unofficial transcript (including those produced in student self-service online systems). Submitted applications will be considered incomplete if unofficial transcripts are provided. If you don’t have a transcript yet you may submit your application without it and send it separately at a later stage but always by the relevant deadline for your chosen programme

A current CV/Resume References: (It is a University requirement that three references are provided)

Referee name Institutional/professional postal and email address of referee

Relationship to you Sealed references enclosed

EITHER (both must be entirely your own original work, except where clearly stated) Check the selection criteria for your course in the relevant course page www.graduate.ox.ac.uk/courses for any specific requirements.Taught courses: A statement of purpose ORResearch and ‘Research Preparation’ Courses: A research proposal ADDITIONAL ITEMS THAT MAY BE COMPULSORY FOR YOUR APPLICATION. (SEE: www.graduate.ox.ac.uk/apply)

Written work 1 (limit to approx 2000 words) (You are required to submit material that is entirely your own original work, except where clearly indicated)

Written work 2 (limit to approx 2000 words) (You are required to submit material that is entirely your own original work, except where clearly indicated)

If your course permits one longer piece of written work (4,000 words) instead of two shorter pieces (you can check this in the selection criteria for your programme on its course page at www.graduate.ox.ac.uk/courses ), please tick this box (You are required to submit material that is entirely your own original work, except where clearly indicated)

Portfolio/CD/audio-visual media

GRE admissions test certificates: (applicable for certain programmes)

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Other items (please tick box(es) as appropriate:

If your first language is not English, or if your first language is English but you are not a national of the UK, Ireland or a majority English-speaking country (see: www.graduate.ox.ac.uk/englishproficiency ) recognised by the UK Home Office , you must either supply an English test result (IELTS, TOEFL, Cambridge CPE or CAE), which must be less than two years old at the start of your proposed programme of study, or submit a letter written by you explaining why you are requesting a waiver to the English language test Only submit a waiver request if you do NOT need a visa to enter the UK. If you require a visa to enter the UK you should not submit a waiver request unless you fulfil the requirements in the Application Guide www.graduate.ox.ac.uk/applicationguide - see “Your Language Skills and Admissions Tests” section

Supporting materials for University of Oxford Scholarship applications Section O: Application Fee Payment

The application fee for each programme of study is £50. You must submit payment in full at the time of application. If you are applying for more than one course, you need to supply separate application forms and payments for each programme.

1. Online payment at www.oxforduniversitystores.co.uk using one of the following: MasterCard, Visa credit card, Switch, Solo, AMEX or Delta debit card. (Please note that the name of the cardholder does not need to match the name of the applicant). Enter the order number (from confirmation of purchase email) in the box below – all have the prefix “OXF”: Please check the code you have entered carefully, as it will be audited; any application with an invalid payment code will not normally be considered:

2. Enclosed payment (in £ UK Sterling, drawn on a UK bank and made payable to “University of Oxford”)

Cheque International Banker’s Draft Please write your name, date of birth and course code on the reverse of your cheque or banker’s draft.

Please note that we do not accept any other form of payment.

Section P: Final Checklist

Please confirm that you have:

Filled out all required sections of the application form

Gathered together all supporting materials required for your programme of study

Requested references from your named referees

Completed ‘Appendix A: Ethnic Background’.

Enclosed the application fee of £50 or provided the payment order number

Please enclose a self-addressed postcard if you wish to receive acknowledgement that your application has arrived. We will send the postcard back to you as soon as we have received and opened your application package. Please note however that this is not a confirmation that your application is complete or that it has arrived on time.

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OXF

Section Q: Declaration

Once you have completed this application form, please read the following statements carefully. By signing this application form you confirm your acceptance of these statements. If you do not sign this form, we cannot process your application.

I confirm that the information I have provided on this application form is (to the best of my knowledge) true, accurate, current and complete; and I agree to notify the University promptly if any information contained on this application form should change, in order to keep it true, accurate, current and complete.

I confirm that all supporting work submitted as part of this application is entirely my own original work, except where clearly indicated otherwise, and does not include any plagiarised elements.

PLEASE NOTE: All admissions decisions taken by the University of Oxford and its Colleges rely on the statements made on the application form and in the supporting materials supplied by you and your referees. This information will be held and used for the purpose of processing your application for study, for student administration and, where relevant, for funding purposes.

If the University, or any College of the University, believes that any information or statement, including references, contained on your application form may not be true, accurate, current and complete, or that any material submitted in support of your application may not be entirely your own original work, except where clearly stated otherwise, it may take any necessary steps to verify that information or statement, or to confirm that any supporting material is entirely your own original work, except where clearly stated otherwise.

As part of the admissions process the University may use a plagiarism detection system. This system screens any written work submitted as part of your application for plagiarism, paraphrasing and collusion. The plagiarism detection system will store on its database any written work submitted for screening. For the University’s definition of plagiarism, please see the Application Guide:

http://www.graduate.ox.ac.uk/plagiarism .

If, in the opinion of the University, or any College of the University, any information or statement, including references, provided on this application form, is not true, accurate, current and complete, or any supporting material is not entirely your own original work, except where clearly stated otherwise, the University, or any College of the University, retains the right to reject your application. If you have been made an offer by the University, or any College of the University, then the University, or any College of the University, may in these circumstances withdraw or amend that offer. If you have been admitted as a student, you may be subject to disciplinary action which could result in your expulsion from the University and your College.

Continued on next page.

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Section Q: Declaration (Continued)

In the course of completing this application form, you have provided the University with personal data. The consent set out below explains how this personal data may be processed by the University.

I consent to the collection, processing, sharing and use of relevant personal data by the University and its Colleges for the purposes of processing my application for study, for administration and (where applicable) for funding purposes, subject to the provisions of the Data Protection Act 1998.

I understand that such personal data may be used and shared with third parties, some of which may be located overseas (including outside the European Economic Area). This may be for the purposes of verifying my identity, qualifications, work experience, references and any submitted work. Where I apply for funding through the University, my personal data may be shared with third parties relevant to that funding application. If my application is successful, my contact details and the course I have applied for may be shared with alumni and student societies and groups (including those outside the European Economic Area) for the purpose of inviting me to events related to student life at the University.

I understand that the University, or any College of the University, will normally only discuss my application with me, unless I have nominated a third-party agent on my application form.

I understand that if any information or statement, including references, provided on or to support this application form is not true, accurate, current and complete, or any supporting material is not entirely my own original work, except where clearly stated otherwise, the University, or any College of the University may process and use this fact as relevant personal data. Such data may be used and shared with third parties, including Higher Education institutions, some of which may be located overseas (including outside the European Economic Area), to the extent necessary for the purpose of preventing fraudulent or dishonest applications for study, funding and/or visas.

I understand that if I become a registered student, any personal data collected by the University as a result of my application will form part of my student record.

Please sign below to confirm acceptance of these statements:

SIGNATURE: DATE:

PLEASE PRINT NAME:

GAO2015/A

APPENDIX A TO APPLICATION FORM GAO2015

CRIMINAL CONVICTIONS

Do you have any relevant unspent criminal convictions?:

Yes No

This question should be answered by all applicants, regardless of nationality or country of residence. For a definition of a relevant unspent criminal conviction and for Oxford University’s policy and procedures in the event of a positive declaration please see the guidance for applicants, found here: www.graduate.ox.ac.uk/applicationguide

GAO2015/B

APPENDIX B TO APPLICATION FORM GAO2015

SOCIO-ECONOMIC INFORMATION

The information you provide in this section does not form part of any assessment of your application and is not made available to those assessing your application. Although it is not required to be completed as part of your application, it would be helpful if you could answer these questions as accurately as possible, since the data will assist research by the University into the development of funding policies to support graduate students. This may include, but is not limited to, the sharing of aggregated statistical data with the Higher Education Funding Council for England (HEFCE) to benefit students from under-represented socio-economic groups. If you are unable to answer a particular question you should omit this and answer the remaining questions.

Where questions relate to the education and employment of your parents, step-parents or guardians, please answer for the two people most closely involved in your upbringing. You will need to select two people to be Parent 1 and Parent 2 before completing these questions, though you do not need to identify them.

Further information on this section of the application form is available in the Application Guide www.graduate.ox.ac.uk/application guide

1.Address

Were you resident in the UK during your lastcalendar year of secondary education (ie. whenyou took your school leaving exams)? Yes No Prefer not to say

If so, please state the full UK post code foryour permanent household address at thattime. (If the format of the post code has subsequently changed, please give the formatof the postcode as it is today _______________________

2.Education and employment

Please state the calendar year in which you took your final exams in your secondary education _______________________

Not applicable Prefer not to say

In the final calendar year of your secondaryeducation, did ‘Parent 1’ have a full undergraduatedegree (eg BA, BSc) or equivalent? (Please tick‘No’ if she/he started studying for such a degreebut did not complete it) Yes No Don’t know Prefer not to say

GAO2015/B

APPENDIX B TO APPLICATION FORM GAO2015 (continued)

SOCIO-ECONOMIC INFORMATION

Please indicate which of the following UK Higher managerial/professional occupations National Statistics Socio-economic Lower managerial/professional occupations Classification (NS-SEC) categories best Intermediate occupations describes the job of ‘Parent 1’ in your final Small employers and own account workers calendar year of secondary education. For Lower supervisory & technical occupations help with categorisation please refer to the Semi-routine occupations Application Guidewww.graduate.ox.ac.uk/ Routine occupations application guide. (If she/he was short-term Never worked and long-time unemployed unemployed (less than 12 months) or retired Prefer not to say at the time, please answer in relation to her/hislast previous job.):

In the final calendar year of your secondaryeducation, did ‘Parent 2’ have a full undergraduatedegree (eg BA, BSc) or equivalent? (Please tick‘No’ if she/he started studying for such a degreebut did not complete it) Yes No Don’t know Prefer not to say

Not applicable as I had no ‘Parent 2’ in the final year of my secondary education

Please indicate which of the following UK Higher managerial/professional occupations National Statistics Socio-economic Lower managerial/professional occupations Classification (NS-SEC) categories best Intermediate occupations describes the job of ‘Parent 2’ in your final Small employers and own account workers calendar year of secondary education. For Lower supervisory & technical occupations help with categorisation please refer to the Semi-routine occupations Application Guidewww.graduate.ox.ac.uk/ Routine occupations applicationguide. (If she/he was short-term Never worked and long-time unemployed unemployed (less than 12 months) or retired Prefer not to say at the time, please answer in relation to her/hislast previous job.):

3.Periods in public care

Have you ever been in public care? If you are Yes No Prefer not to say unsure what this means please refer to theApplication Guide www.graduate.ox.ac.uk/application guide

If ‘Yes’, please indicate the total length of Less than 3 months Time you have been in care 3 months to 1 year

More than 1 year Not applicable Prefer not to say

GAO2015/B

4.Household income

Please estimate your combined annual £0 - £16,000 Household income for 1 September 2014 - £16,001 - £25,000 31 August 2015. If you are unsure what this £25,001 - £42,600 Means, please refer to the Application Guide £42,601 - £62,000 www.graduate.ox.ac.uk/applicationguide £62,001 +

Prefer not to say

This should include:

“take-home pay” (salary after tax and other deductions) Income from pensions or state benefits Rental income from any property/properties in which you do not live Interest on savings

It does not include any bonuses or benefits in kind. Do not subtract any household bills.If a salary is part-time, please include the actual amount earned (after tax and other deductions), not the full-time equivalent. If any income is not in Pounds Sterling, please convert it using today’s exchange rate using a currency-converter, such as www.currency-converter.org.uk/

5.Dependants

For how many children (up to and including _____________ the age of 18, and children over 18 in full-time education or training) are you financially Prefer not to say responsible?

In addition to anyone you have included in the _____________ previous question, for how many other persons (eg. a grandparent) are you financially responsible? Prefer not to say

UNIQ summer school (for those with UK secondary education only)

Have you ever applied for a place on the UNIQSummer school programme at the University of Oxford? www.uniq.ox.ac.uk Yes No Prefer not to say

If ’Yes’, in what year did you apply? _____________ Not applicable Prefer not to say

If ‘Yes’, were you offered a place on the programme? Yes No Not applicable

Prefer not to say If you were offered a place, did you attend the UNIQ summer school?

Yes No Not applicable Prefer not to say

GAO2015/C

APPENDIX C TO APPLICATION FORM GAO2015

ETHNIC BACKGROUND

The University is required under statute to seek and return information about the ethnic background of all its applicants for HESA (the UK Government’s Higher Education Statistics Agency). The information provided is used to monitor rates of participation in Higher Education by particular groups of people.

This information will not form part of any assessment of your application.

Please enter in the box below the appropriate code which best describes your ethnic background.

10 White

15 Gipsy/Traveller

21 Black or Black British – Caribbean

22 Black or Black British – African

29 Other Black background

31 Asian or Asian British – Indian

32 Asian or Asian British – Pakistani

33 Asian or Asian British – Bangladeshi

34 Chinese

39 Other Asian background

41 Mixed - White and Black Caribbean

42 Mixed - White and Black African

43 Mixed - White and Asian

49 Other Mixed background

50 Arab

80 Other ethnic background

90 Not known

If you do not wish to specify your ethnic background, please enter code 98.

GAO2015/D

APPENDIX D TO APPLICATION FORM GAO2015

UNITED KINGDOM HOME OFFICE LIST OF MAJORITY ENGLISH-SPEAKING COUNTRIES

AustraliaCanada New ZealandUnited States of AmericaCaribbean: Antigua and Barbuda, The Bahamas, Barbados, Dominica, Grenada, Jamaica, St Kitts and Nevis, St Lucia, St Vincent and the Grenadines, Trinidad and TobagoCentral and South America: Belize, Guyana