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BIRKBECK INSTITUTE FOR THE HUMANITIES

LONDON CRITICAL THEORY SCHOOL


Summer School 7
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July !"
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July #$!%
A&&l'c(t'o) Form
*le(+e ty&e or ,r'te cle(rly ()- +e)- th'+ .orm ,'th your &er+o)(l
+t(teme)t /y em('l to Jul'( E'+)er 01e'+)er2//31(c1u3 /y Fr'-(y #"
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M(rch #$!%
!1 *ERSONAL 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:
mail:
Telephone:
#1 4UALIFICATIONS
Please tic! the bo" for the hi#hest $ualification to date:
PhD/MPhil
%i#her de#ree from &' &ni(ersity (e)#) M*/MSc/MSci/MPharm/Mn#)
%i#her de#ree from another uni(ersity
51 *ERSONAL STATEMENT
Please state in no more than +,, -ords -hy you -ould li!e to ta!e part in the
Summer School) .f necessary use a separate sheet of paper) A)- &le(+e
+t(te '. you (re ( retur)')6 +tu-e)t1

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