Further Study Application Form FOR APPROVAL TO UNDERTAKE PROGRAMME OF STUDY Section 1. To be Completed by the Applicant Full Name: Job Title and : Telephone No./ Division/Department Ext Do you meet the employee eligibility criteria regarding Y N □ □ service (including post qualification criteria) What Qualifications do you currently hold? Have you previously received support Y N □ □ from UL for Further If yes, please expand: What is your Proposed Course? Staff Number: Student Number (if assigned): How long will the full What Qualification course last? will you hold if successful? Commencement date of Which year of the course For years have the course are you starting? you previously been funded? Name and Address of Institute Applicants departmental cost code What study / course M T W Th F Additional Comments attendance time will you need to complete the course in the coming year? Full Day Release Half Day Release Evening Only Weekend Seminars Exam/study leave dates What is the What What full amount of payment is payment is the due for the due for the programme current year? current year? (max that will be paid for programme of study):
Further Study Application Form FOR APPROVAL TO UNDERTAKE PROGRAMME OF STUDY Section 1. To be Completed by the Applicant Full Name: Job Title and Telephone No./ Ext Division/Department Do you meet the employee eligibility criteria regarding service (including post qualification criteria) Y □ N □ What Qualifications do you currently hold? Have you previously received support from UL for Further Y □ N □ If yes, please expand: What is your Proposed Course? Staff Number: Student Number (if assigned): How long will the full course last? What Qualification will you hold if successful? Commencement date of the course Which year of the course are you starting? For years have you previously been funded? Name and Address of Institute Applicants departmental cost code What study / course attendance time will you need to complete the course in the coming year? M T W Th F Additional Comments Full Day Release Half Day Release Evening Only Weekend Seminars Exam/study leave dates What is the What What payment is due for the current year? full amount of payment is the due for the programme current year? (max that will be paid for programme of study): :
TF012%20Further%20Study%20Application%20Form.docx