Yale UCL Exchange Programme Application Form

Doctoral School Yale UCL Collaborative Student Exchange Programme Application Form
Please read the Yale UCL Terms & Conditions carefully before submitting your application. At the bottom of each page there is an option to save your application form so that you are able to return and complete it at a later date.
Personal Details
Title*
Name*

First NameLast Name
UCL email address*
example@example.com
Student UPI (alphanumeric code on UCL ID card)*
Student UCL ID number*
Fee status*

HomeOverseas
I agree to share my contact details with other Yale/UCL exchange scholars*

Your Studies
Faculty*
Department*
Registered PhD programme*
Please provide the working title of your research proposal/thesis. *

Proposal
Which 2023/24 round are you applying for? *
Deadlines: Round 1: Tue 24 Sept 2024 (earliest start date: Jan 2025) Round 2: Tue 25 March 2025 (earliest start date: August 2025)
Proposed Yale Supervisor*
Proposed Yale Department (this is normally the department of the supervisor)*
Is your proposed supervisor affiliated with the Yale Graduate School of Arts and Sciences?*
Proposed Start Date*

DayMonthYear
Proposed End Date*

DayMonthYear
Note: Exchanges should be a minimum of 3 months (90 days) and longer periods are considered if specifically agreed to by the student and proposed Supervisor.
Proposal *

Please state how the visit will benefit your research, detailing the specific questions and aspects of your work that you will be investigating there. As ambassadors for UCL, Exchange participants will be expected to make the most of their time at Yale by engaging as fully as possible with Yale's research community. Please provide information on how you plan to engage beyond the confines of your individual project and comment on how this Exchange may benefit your career.0/500

Supervisor's Endorsement

Download the word document via the link provided and send to your Principal Supervisor to fill in and sign. Once complete, please upload to the relevant box below.
Link to download supervisor endorsement form (doc)

The link will open up into a new tab and you should see a download option in the top right hand corner.
Upload supervisor's endorsement*

doc, docx & pdf format accepted.
Cancelof

Head of Department's Endorsement

Download the word document via the link provided and send to your Head of Department to fill in and sign. Once complete, please upload to the relevant box below. Please note: it is acceptable for this form to be completed by the HoD's appointed representative e.g. the Departmental Graduate Tutor.
Link to download HoD endorsement form (doc)

The link will open up into a new tab and you should see a download option in the top right hand corner.
Upload HoD's endorsement*

doc, docx & pdf format accepted.
Cancelof

Proposed Yale Supervisor Endorsement

Please provide a letter or email from your proposed Yale Supervisor confirming that they agree to your exchange visit. A screenshot of an email in PDF or jpg/jpeg format is acceptable.
Please upload letter/email from your proposed Yale Supervisor*

doc, docx, pdf, jpg, jpeg format accepted.
Cancelof

Funding the Exchange
Do you receive funding towards any of the following for your PhD at UCL?*

Tuition feesStipend / SalaryOther financial support, e.g. consumables/travelNo funding (completely self-funding)
Is there additional funding available from your funder or programme RTSG fund that can go towards the Exchange?*
If you are a funded student and have not checked whether additional funding is available, we advise that you look into this before completing the following section.
Proposed source of funding for the Exchange*
Note: if you select option 'Scholarship/Studentship/Personal (or equivalent) funds ONLY' you will not be prompted to apply for the Yale-UCL Bursary.
Yale UCL Exchange Bursary - Estimated Costs & Contributions

The maximum amount that can be awarded is £6,000. Please review T&Cs for further details.
Travel
Provide approximate cost of travel e.g. flight, shuttlebus etc. Note: it is recommended to take a flight to New York and then use either MetroNorth or the Airport Shuttle to reach Yale in New Haven, CT.
Travel details*
Total travel cost (£)*
Accommodation Costs
Please provide details and approximate cost of your accommodation. Please view our Terms & Conditions for further information.
Accommodation details*
Total accommodation cost (£)*
Visa Costs
Provide details and approximate cost of your visa.
Visa details*
Total Visa cost (£)*
Health Insurance &
UCL has a business travel insurance policy that will insure UCL students, that are UK residents, for a research trip up to 12-months. For full details on free UCL insurance cover and to register please check: http://www.ucl.ac.uk/finance/insurance/travel and see our Terms & Conditions for further information. If you and/or your exchange is ineligible for UCL Health Insurance cover and/or you require additional cover, please provide details in the sections below.
Health insurance details
Total health insurance cost (£)
Research Expenses
Please note that the host department at Yale is expected to provide and support research costs.
Research expenses details
Total research expenses cost (£)
Overall Costs
Total estimated expenses*
Have you been assured any funding from other organisations/funders?*

YesNo
Please provide details of your assured funding*
Amount requested from the Doctoral School (£)*

Signature
Please note that personal details provided on this form will be held for application processes only. For more information on UCL's privacy policy and GDPR click here: https://www.ucl.ac.uk/legal-services/privacy/ucl-prospective-students-enquirers-and-applicants-privacy-notice

Further details on intellectual property rights can be found in UCL's Policy Statement on Intellectual Property Rights/Copyright in Relation to Students: https://www.ucl.ac.uk/enterprise/about/governance-and-policies/ucl-intellectual-property-ip-policy
Signature*

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Doctoral School Yale UCL Collaborative Student Exchange Programme Application Form

Personal Details

Your Studies

Proposal

Supervisor's Endorsement

Head of Department's Endorsement

Proposed Yale Supervisor Endorsement

Funding the Exchange

Yale UCL Exchange Bursary - Estimated Costs & Contributions

Travel

Accommodation Costs

Visa Costs

Health Insurance &

Research Expenses

Overall Costs

Equal Opportunities Monitoring

Diversity data

Signature