MA Art, Psyche & the Creative Imagination CompanyThis field is for validation purposes and should be left unchanged.1. Personal DetailsFirst Name(Required)Surname(Required)Permanent Address(Required) Street Address Address Line 2 City County / State / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone(Required)Nationality(Required)Email Address(Required) Date of Birth(Required) PPS NumberIf you do not have a PPS number you will need to apply for one by contacting cis@welfare.ie Gender(Required) Female Male Non-Binary Prefer not to say Previous/Current TUS Student NumberHave you been living in an EU country for 3 of the last 5 years?(Required) Yes No Have you been living in an EU country for 3 of the last 5 years? Yes No 2. QualificationsState the highest qualifications you hold or expect to hold prior to admission, and any other qualifications relevant to your application.2.1 Qualification 1Name and Address of Instution Attended(Required)Major Areas of Specialisation(Required)Course Start Date(Required) Course End Date(Required) Have you received your results for this course?(Required) Yes No Please provide date you expect to receive your results(Required) Qualification Attained(Required)Award Level (e.g. 1st Class Honours)(Required)Please upload a transcript of results for this qualification here(Required)Max. file size: 10 MB. 2.2 Qualification 2 (If applicable)Name and Address of Instution AttendedMajor Areas of SpecialisationCourse Start Date Course End Date Qualification AttainedAward Level (e.g. 1st Class Honours)Please upload a transcript of results for this qualification hereMax. file size: 10 MB. 2.3 Qualification 3 (If applicable)Name and Address of Instution AttendedMajor Areas of SpecialisationCourse Start Date Course End Date Qualification AttainedAward Level (e.g. 1st Class Honours)Please upload a transcript of results for this qualification hereMax. file size: 10 MB. 2.4 Qualification 4 (If applicable)Name and Address of Instution AttendedMajor Areas of SpecialisationCourse Start Date Course End Date Qualification AttainedAward Level (e.g. 1st Class Honours)Please upload a transcript of results for this qualification hereMax. file size: 10 MB. 3. Details of Other Courses (If applicable)e.g. In career and short courses3.1 Course 1Name and Address of Instution AttendedMajor Areas of SpecialisationCourse Start Date Course End Date 3.2 Course 2Name and Address of Instution AttendedMajor Areas of SpecialisationCourse Start Date Course End Date 4. Previous Work ExperiencePlease enter current and previous employer details over the last three years4.1 Employer 1Employer Name and AddressEmployer Phone NumberJob Title/Nature of WorkDate of Employment From Date of Employment To 4.2 Employer 2 (If applicable)Employer Name and AddressEmployer Phone NumberJob Title/Nature of WorkDate of Employment From Date of Employment To 4.3 Employer 3 (If applicable)Employer Name and AddressEmployer Phone NumberJob Title/Nature of WorkDate of Employment From Date of Employment To 5. Personal Statement (500 words max)Please state your interest in pursuing postgraduate studies in this area? Please also mention any interest/experience you might have in this area, and a brief elaboration on your psychological readiness for this programme (example: include prior knowledge and experience related to depth psychology concepts, ability to evaluate and reflect on the nature of the psyche in relation to self and within participation in group processes, access and awareness of psychological supports.)6. Disability DisclosureIf you consider yourself to have a disability or significant health problem, (please tick the relevant box below)(Required) Yes No If yes, please email disability.midwest@tus.ie to discuss your support requirement.7. Referees7.1 Academic RefereeReferee 1 Name(Required)Referee 1 Address(Required)Referee 1 Email(Required) 7.2 Academic or Professional Referee (Artists, Curators, Designers etc.)Referee 2 Name(Required)Referee 2 Address(Required)Referee 2 Email(Required) 8. Do you wish to apply as a Recognition of Prior Learning (RPL) applicant?(Required) Yes No You may apply to be considered for RPL based on your history of certified learning and/or your experiential learning. If you select to have your prior learning considered, you will subsequently be asked to complete an RPL Application Form. Find out more about RPL here.9. Declaration(Required) I confirm that the information given on this form is true, complete and accurate and that no information requested, or material information has been omitted. I give my consent to the processing of my data by TUS, Limerick School of Art and Design.
