1
SECTION 1
SECTION 2
Name (block capitals):
Sur
name: Forenames
:
1
Application for consideration
as a research scholar
T
itle: (Dr, Mr, Mrs, Ms, other)
2
Marital Status:
5
Date of Bir
th:
3
Nationality:
(a) Cur
rent (b) Previous
4
Proposed Dates of Visit to the School
From: To:
6
Field(s) in which research is to be carried out (if a particular research project is involved, please specify)
7
If you wish to attend specific lecture courses or seminars, please indicate which (or what kind) you have in mind
8
This for
m, when completed, should be returned to: The Departmental Manager,
(Depar
tment which you are applying to)
,
London School of Economics and Political Science, Houghton Street, London WC2A 2AE, England.