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Further Enquiries:
Frome Road
Level 5, Medical School North Bldg
The University of Adelaide
ADELAIDE SA 5005
AUSTRALIA
Email

Telephone:   +61 8 8303 5571
Facsimilie:   +61 8 8224 0685

 

Application for Admission

International Programme in Addiction Studies
Master of Science in Addiction Studies

To apply for the Master of Science in Addiction Studies, please submit this form online and return the completed, signed application via mail, along with three sealed letters of reference, your curriculum vitae and personal statement, and original academic transcripts in a single envelope to:

Femke Buisman-Pijlman
Discipline of Pharmacology
Level 5, Medical School North
Frome Road
Adelaide SA 5005
Australia

All mailed application documents must be received by 1 July 2010.

Online Application

Follow the instructions for each question carefully and complete all requested fields (denoted by an asterisk*).

Your details

Family name*First name*Middle name
Sex*Male   FemaleDate of birth* (dd/mm/yyyy)
Current
Residential
Address

Number:  Street:

City:  State:

Country:  Postal Code:

Telephone
number*		 (include Country and area code)

Email address*

(used for all 
communication)

Postal Address
(only if different to residential)		Number:  Street:

City:  State:

Country:  Postal Code:

Place of birth*Country of birth*
First language*Social Security number
(US Applicants only)

Entry year and Status

Preferred year of entry*
Enrolment status

Part-time

Full-time

Undecided

Standardised Testing

Note: only information on TOELF or IELTS scores are mandatory, and then only for students from a country where English is not the first language or who have not successfully completed a degree studied in the English language.

TestScoreDate taken
TOEFL (Test of English as a Foreign Language) (dd/mm/yyyy)
IELTS (INT English Language Testing Service) (dd/mm/yyyy)
GRE (Graduate Record Examination-Aptitude) (dd/mm/yyyy)
Other test (please identify)
(dd/mm/yyyy)

Educational background

Please fill in the details of at least one previous place of education as outlined in the application instructions.

 Name and location of Institution
(city and country)
Academic level (BA, MSc, PhD)		Dates of Attendance
(from month/year to month/year completed)		Major field of study and Grade point average/grade point average scale (e.g, 3.2/4.0;8/10) or classification (pass, distinction) where applicableDegree, certificate or diploma awarded and date awarded
or to be awarded.
1.*
2.
3.
4.
5.
6.

Curriculum vitae

Please attach your curriculum vitae as a separate document including all items as outlined in the application instructions*:

Academic references

List the names, addresses and positions of three persons, preferably professors, supervisors, or professionals, who are completing reference forms for you. At least one reference must be from an institute of Higher Education.

First referee*
Name
Position
Address
Second referee*
Name
Position
Address
Third referee*
Name
Position
Address

Ethnic origin

Please tick one of the following options.
Note: providing information on ethnic background is not compulsory.

Aboriginal and/or Torres Strait Islander

African-American

Asian or Asian British

Other Asian Background

Bangladeshi

Black African

Black Caribbean

Other black background

Chinese

Hispanic or Latino

Indian

Other Indian background

 

Irish

Native Hawaiian or other Pacific Islander

Native American or Alaskan Native

Mixed (White and Black Caribbean)

Mixed (White and Black African)

Mixed (White and Asian)

Pakistani

Persian

White/Caucasian (British)

White/Caucasian (Irish)

White/Caucasian (other)

Other background not listed:

How did you first hear about our programme?*
What influenced you to apply?*

Personal statement

On a separate sheet, please write a personal statement in which you discuss the following:

  • your reasons for seeking to obtain this degree, including your career goals and how you envision that the programme will help you meet those goals
  • prior life/work experiences that relate to your interest in and aptitude for the programme, and
  • your perception or your capacity to complete the programme successfully.

Attach personal statement*:

Submit your application

Please ensure you've filled out all necessary form fields and uploaded all required documents

(as denoted by an asterisk*) before you submit this form.

By submitting this form, you declare that the information provided in this form is accurate and thruthful.

  

 

 

Or, you can reset the form and start again.