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BIRKBECK INSTITUTE FOR THE HUMANITIES LONDON CRITICAL THEORY SCHOOL Summer School 1st July 12th July

y 2013
Application Form
Please type or write clearly and send this form with your personal statement by email to Julia Eisner j.eisner@bbk.ac.uk by Friday 22nd March 2013 1. PERSONAL DETAILS Title: Dr/Mr/Ms (please circle/delete) Surname/Family name:

First name(s): Male/Female (please circle/delete) Date of birth: Permanent address:

Postcode/Zip: Country: Email: Telephone:

2. QUALIFICATIONS Please tick the box for the highest qualification to date: PhD/MPhil Higher degree from UK University (e.g. MA/MSc/MSci/MPharm/MEng) Higher degree from another university 3. PERSONAL STATEMENT Please state in no more than 500 words why you would like to take part in the Summer School. If necessary use a separate sheet of paper. And please state if you are a returning student.

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