1. Personal Details
Name:
Date of Birth:
Contact Address:
Phone Number:
Mobile Number:
Fax Number:
Email:
2. Education and Qualifications
Current University:
Current Programme of Study (e.g. Hons, MSc):
Expected Date of Award:
Undergraduate Degree Subjects:
Undergraduate Degree Grade / GPA:
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3. Referee Contact Details (two academic referees)
Name of Referee 1:
Email address of Referee 1:
Name of Referee 2:
Email address of Referee 2:
4. Research
Research Interest(s):
Academic Contact at UQ: (Optional):
Motivation for undertaking PhD at UQ
(in no more than 100 words):
5. Other Relevant Details Eg. Scholarships, Awards,
Research Experience, Publications, etc.
Details:
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