COLERIDGE STUDY WEEKEND

BURSARY APPLICATION

 

Please return to Peter Larkin as an attachment: Peter.Larkin@warwick.ac.uk

 

 

Name:

Address………………………………………………………...

…………………………………………………………………

…………………………………………………………………

Post Code……………………....Tel:…………………………

Telephone:

Email:

 

University:

Departmental Address:

…………………………………………………………………

…………………………………………………………………

Post Code……………………...

 

 

 

Title of Thesis:

Brief Description of Thesis:

 

 

 

Bursary Application; please give your reasons for applying, outlining your financial situation:

Academic Referee; please supply the name, email address or contact method for your supervisor or other academic referee; please make sure they are willing to respond quickly: