2016 Application Foradmission: Supplementary Form

Faculty of Science: Honours Programs 2016 Application for Admission: Supplementary Form

GENERAL INSTRUCTIONS: This form is to be completed for all students seeking admission to any honours programs offered by the Faculty of Science (see below). Before submitting the forms ensure that your internal UTS supervisor has signed the second page of this supplementary form and completed any necessary supporting documentation. Upon completion, please email this from to the Faculty Academic Administration Team at [email protected].

Please indicate your program preference by ticking the appropriate box.

C04267 Master of Science (Honours) in Biomedical Engineering C04267 Master of Science (Honours) in Forensic Science C04267 Master of Science (Honours) in Marine Sciences and Management C04267 Master of Science (Honours) in Mathematical and Statistical Modelling C04267 Master of Science (Honours) in Medical Biotechnology C09020 B Science (Honours) in Mathematics C09022 B Biotechnology (Honours) C09023 B Science (Honours) in Biomedical Science C09026 B Science (Honours) in Applied Chemistry C09029 B Science (Honours) in Environmental Science C09031 B Medical Science (Honours) C09035 B Science (Honours) in Applied Physics C09046 B Science (Honours) in Nanotechnology C09050 B Forensic Science (Honours) in Applied Chemistry C09077 B Medicinal Chemistry (Honours) C09078 B Biomedical Physics (Honours)

C09099 B Science (Honours) in Analytics

To be completed by the student:

Family Name: ………………………………………………………………….……….. First Name: ………………………………………………………………………..

UTS Student ID: …………………………………… UTS Student Email Address: …………………………………………………………………………………….. (NB. an alternate email address can be provided if you don’t have a UTS account, but this must be updated to UTS email address once you officially enrol) Phone No: Home: ………………………………………………………………..…… Mobile: ………………………………………………………………………......

Project Title: ………………………………………………………………………………………………………………………………………………………………..…….…

Supervisor (s ):……………………………………………………………………………………………………………………………………….……………………….……..

1 2 3 Project overview /Preferences / Areas of interest [cross out those that do not apply]: ………………………………………………………………………………………………………………………………………… ………………………………………..…..…… ………………………………………………………………………………………………………………………………………… …………………………………..…..………… ………………………………………………………………………………………………………………………………………… …………………………………..………..……

SigFACULTYnature: …………………………………………………………………… USE ONLY .. Date: ……………………………………………………………………….…..

1 [For students who have selected a topic and supervisor] Please provide 1-2 page summary of what you will be doing and how. Please attach this summary Facultyto this form. of Science supplementary form- Admission 2016 The following section is to be completed by the supervisor(s) prior to submission. [This section applies to all students who provided a project overview]

Internal Supervisor I have discussed the above project with this student and I am willing to act as a supervisor. Name: ……………………………………………………………………………………. Signature: …………………………………………………………………….. Date: …………………………………………………………………………….. The following source(s) of funds will be used to support this student: Research Grant(s) Title: …….……………………………………………………………………………………………………….…………………….……………….. Granting Body(ies): ……………………………………………………………………….… Amount(s):.………………………………………………..……….. School Funds School: ………………………………………………………………….. Amount: ……………………………………………….……………..

The supporting documentation required for approval of this application includes the following. [Please check the appropriate box(es).] This documentation is to be forwarded to the School Honours (Advisory/Management) Committee by the supervisor prior to the approval meeting. □ EHS Risk Assessment □Status of Human Ethics Approval

□Status of Biosafety Approval □EHS Certification by External Supervisor

□Status of Animal Ethics Approval □Honours proposal (MMB – please use attached)

□Other, please specify ……………………………………………………………………………………………………………………………………………………

External Supervisor/Co-supervisor* (*where applicable)

I have discussed the above project with this student and I am willing to act as a supervisor.

Name: ……………………………………………………………………………… Signature: …………………………………………………Date:……………..….. Email address: ………………………………………………………………….. Phone number:…………………………………………………………………….. Position: …………………………………………………………………………… Affiliation*: ……………………………………………………………………..….. Full postal address:…………………………………………………………………………………………………………………………………………………………….…. *The following resources (external to the Faculty) will be made available for the purposes of completing this project: ……………………………………………………………………………………………………………………………………… …………………………………………….……

……………………………………………………………………………………………………………………………………… ………………………………………….……..… Students, this form may now be emailed to the Faculty Academic Administration Team at [email protected] . APPROVALS To be completed by Head of School

School facilities and resources required for the proposed project will be made available. School: ……………………………………………………………………………………. Signature: ……………………………………………………………………..

Date: …………………………………………………………………………….. To be completed by the Chair of the School Honours (Advisory/Management) Committee:

Decision of Faculty Nominee: o Approved o Refused Signature: …………………………………………………………………….. Date: ……………………………………………………………………………..

The Chair of the School Honours (Advisory/Management Committee) should return all forms to the Faculty Academic Administration Team upon a decision being made.

Faculty of Science supplementary form- Admission 2016