Honours Program Application Form for Students



Honours Degree Application Form for Students Before you complete this form, please ensure that you have contacted the Postgraduate Research Coordinator for any guidance on the application and enrolment process into the Honours Degree. Applicants are required to organise a supervisor for their intended thesis, as outlined in the Bachelor of Health Science (Specialisation) (Honours) Handbook. All documentation must be submitted as a completed application pack to the Postgraduate Research Coordinator at pgr@endeavour.edu.au.PERSONAL DETAILSTitleGiven NameFamily NameAddress EmailPhone Date of BirthGenderEndeavour Student number (if applicable)ACADEMIC QUALIFICATIONS Please list all tertiary level qualifications. Please attach all academic transcripts (excluding those undertaken at Endeavour College).InstitutionQualificationCompletion dateGPA/GradeResearch Component % (if applicable)PROPOSED STUDY DETAILSOnline intake date (proposed): Study mode: ? Full time (1 year) ? Part time (1.5 – 2 years)Study modality: ? Acupuncture ? Myotherapy ? Naturopathy ? Nutritional and Dietetic Medicine RESEARCH DETAILS Please ensure that you have discussed and agreed with your supervisor/s on the research project prior to completing this section and the Honours Degree Research Project Proposal Form. Please ensure that the research project form is complete and attached to this application form. Nominated research project title:RESEARCH EXPERIENCEPlease attach an abbreviated academic curriculum vitae (CV) that outlines any research experience such as current or previous employment in a research role, authorship of peer-reviewed publication with additional peer-reviewed publications, author of a published book (peer-reviewed), author of a book chapter (peer-reviewed), plenary presentations at peer-reviewed conferences, published abstracts (peer-reviewed), or oral/workshop presentations at peer-reviewed conferences. For each publication, please provide the full citation in your CV (for assistance with Academic CV development, please contact the Postgraduate Research Coordinator).Attached?N/A?ACADEMIC REFEREESPlease provide two (2) academic referees who can comment on your academic performance and potential to undertake research. Please ensure that each referee has completed the Honours Degree Academic Referee Form.REFEREE 1TitleGiven NameFamily NameEmailPhone Position Institution REFEREE 2 TitleGiven NameFamily NameEmailPhone Position Institution COMPLETION CHECKLIST ? I have completed all sections of the above Honours Degree Application Form for Students? I have discussed the research project with a supervisor/s and included their signatures where required? I have completed and attached my Honours Degree Research Project Proposal Form? I will ensure that the Honours Degree Academic Referee Forms are submitted to pgr@endeavour.edu.au ? I have attached my completed Honours Degree Student Curriculum Vitae to outline my research experience (if applicable)? I have attached a certified copy of my (non-Endeavour) academic transcript(s)? I have completed and attached a Working with Children check or police check (based on State or Territory requirements – see the College’s Working with Children Checks Policy)? I have completed and attached a certified copy of my valid First Aid Certificate? I have signed the declaration below and understand the application and enrolment processDECLARATIONI declare that all information on this Application Form is correct and complete and that I have met the eligibility conditions as stated in the College’s Bachelor of Health Science (Specialisation) (Honours) Handbook.I have read and understand the requirements of the Degree as laid out in the College’s Bachelor of Health Science (Specialisation) (Honours) Handbook. I also understand that the College reserves the right to seek verification of the information supplied by me. SignatureDateOFFICE USE ONLYDate Received Applicant Notified Filed Reviewed by Postgraduate Research CoordinatorApproved / DeniedSignatureDate ................
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