Postgraduate Studies Application Form
Postgraduate Research Courses at NUI Maynooth - 2010 Entry


 BIOGRAPHICAL INFORMATION:  ( * question MUST be answered ) ( ** question must be answered by Irish Nationals)
                   
 Surname * :
 First Names * :
 
 Name under which Primary Degree conferred (if different from above):
 Surname:
 First Names:
 
 Date of Birth * : / / dd/mm/yyyy
 PPS Number ** :    
 
 Gender * :  Male Female
 
 Medical Condition/Disability * :  Yes No   (If you selected yes please click here
 
 Address for Correspondence * : Rep. of Ireland Other Country
   You may use commas as
   separators in address lines,
   if necessary.
   Do not enter this in the previous line.
 
 Main Contact Number * :   -  
 Mobile Telephone:       
 Work Telephone:   -  
 
 (Enter International Agent's email address if applicable)    
 International Agent's name:
 International Agent's e-mail address:
 Confirm International Agent's e-mail:
 
 Country of Nationality * :
 Country of Birth * :
 
 
 RESEARCH PROPOSAL
 (You may only make one programme choice)
 (To look up programme codes, click on the following button)  
 
 
     Programme Code  Proposed Start Date
   *   
   Proposed Title: 
   Proposed Topic: 
   Have you discussed the proposed topic with a member of the relevant Department?        Yes  No
   If yes, select Department / Member name:     
   If your Department member name is not listed, please email postgrad.dean@nuim.ie to request your member name is added.
 
   Have you received Scholarship Funding for this programme?   Yes  No
   Is research to be conducted by Distance Mode?  Yes  No
   Details of Host institution or company: 
   Proposed Supervisor of Host institution or company: 

 
 
 Most recent Educational Institution Attended * : 
 
 Applicant's Current Status * :  Current NUI Maynooth Student NUI Maynooth Graduate Other Applicant
 
 NUI Maynooth Student Number (if applicable):   
 

 I wish to continue with my application.
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