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Application for admission: Scientific Writing module (HMS771/772/871/873) Due Date: NO LATER than 2 weeks before the Module Date. MODULE DATE: ___________(Please note that this is only an application for admission form NOT a module registration form)Please submit electronically to Mrs Kathy Pieterse (kathy.pieterse@up.ac.za) and “cc” Mr Reuben Semenya (reuben.semenya@up.ac.za) and “cc” Module Coordinator NB: You will only be allowed to attend the module once this form is signed/approved by your supervisorName and SurnameDegree/Diploma registered Year first registered for Diploma/DegreeStudent numberE-mail addressTitle of your draft research report/dissertation/thesisName of target journal (and impact factor) for manuscript submissionThe following section needs to be completed together with your clinical/research supervisor:Name of supervisorEmail Programme / TrackType of research method(s)QuantitativeQualitativeMixed Other (Literature Review, HRA, etc.)Stage of research Data analysisDraft report readyResearch completedThe student has progressed with the research and advised to attend the module.The student applying to attend the Scientific Writing module does so with my approval.The student will bring a draft journal article/research report upon attendance.I shall be available during the module to discuss modifications with the student.N.B. Students who have NOT completed data collection will not be allowed to attend the class. Signature: ________________________ ___________________Supervisor DateSignature: ________________________ ___________________Student Date ................
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