A. Personal details (as they appear in the postgraduate application that you have already submitted) Home address:

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1 School of Media, Film and Music MA Scholarship UK/EU and Overseas Application Form Important: Please read the notes on page 5 before completing this form. To be eligible to apply, you must have been offered a place on an MA programme in the School of Media, Film and Music, starting in October Complete the form carefully, and fill in all the sections, otherwise delays may occur when processing your application. A. Personal details (as they appear in the postgraduate application that you have already submitted) Surname/family name: Home address: First name: Other names: Fax - Male/female Office use only: Ranking: Date of birth (day/month/year) School: Status: / / Address for correspondence (if different) B. Programme of study at Sussex Please mark X in one of the boxes below to show the degree you have applied for Film Studies Gender and Media Studies Media and Cultural Studies Creative Media Practice 1 of 5

2 Digital Documentary Digital Media Journalism and Media Journalism and Documentary Multimedia Journalism Music Opera and Music Theatre Composing Sonic Media Please tell us your postgraduate application number (your application cannot be processed without this) 2 of 5

3 C. Education qualifications Please list qualifications and grades which you have already obtained or for which you are still studying: Dates School, university or college Qualification (eg high school certificate, degree) Subject Grade, GPA Date obtained or expected D. Work experience Please describe any work experience which is relevant to your proposed study programme: Dates Name of employer/ organisation Job title and responsibilities E. Finances In fairness to other applicants, we are unable to consider applications from candidates who have not already secured sufficient funds to meet their tuition fees and living expenses at the time of application (after taking account of the possible award of a Media, Film and Music MA Scholarship). Please state below how your tuition fees and living expenses will be met: 3 of 5

4 F. Personal statement Media, Film and Music MA Scholarships will be awarded to students who possess the highest academic ability and potential; not on the basis of financial need. The selectors will pay special attention to the information you provide below. Please tell us about your academic achievements and ambitions. In particular, please state why you believe that you should be considered for this Scholarship: G. Declaration I hereby declare that I have understood and comply with the Eligibility criteria, and I make a true statement about my details. Signature: Date: 4 of 5

5 Notes for completing the application form Eligibility criteria Applicants must: have been offered a place on one of the following Masters degrees in the School of Media, Film and Music: Film Studies Gender and Media Media and Cultural Studies Creative Media Practice Digital Media Digital Documentary Journalism and Media Journalism and Documentary Multimedia Journalism Music Opera and Music Theatre Composing Sonic Media commence the degree in October 2011 (awards cannot be deferred to subsequent years) Notes: Four scholarships are available. Each is worth 5,000 Current Sussex undergraduate students are eligible to apply How to complete the form 1. Please complete the application form in type or write in CAPITAL letters and BLACK ink. Remember to include your application number. 2. Please quote your address as all correspondence will be via Please make a copy of the form for yourself before sending it to Sussex. 4. When completed, you should return the form to arrive by 1 May 2011 by or post to: Mrs Pat Mounce School of Media, Film and Music Silverstone Building University of Sussex Falmer Brighton BN1 9RG ENGLAND p.a.mounce@sussex.ac.uk 5 of 5