ࡱ> `c_U @bjbjnn 3FaaV |||||8\$T[>xxxxx=======$AC=E|=||xx4>R|x|x==68(;xpXm<:=+>0[>::YDYD8;;YD|;==8j[>YD B B:  For office use:Database Reference Number:Subject:Purchase transaction number: Free of chargeAcknowledged receipt?Comments: THE ROYAL COLLEGE OF PATHOLOGISTS Examinations Department 6 Alie Street London E1 8QT Tel: 020 7451 6745/760 Part 2 written project application form Dissertation / casebook / PhD / MD thesis / published papers A proposal for your written project must have been approved by the College before submission of the finished project and this application form. Please also note that the Part 2 project must be submitted to the College at least four months before the closing date of the Part 2 examination session for which the candidate wishes to enter in specialties where this remains applicable. You must read the Regulations and Guidelines for College Examinations and the relevant specialty section before completing this form. SECTION A TO BE COMPLETED BY THE CANDIDATE Title (Dr, Prof, Mr, Mrs, etc.) Surname (block capitals) Forenames . Work address .. .. ............................................................ Postcode .. Current position . Preferred telephone number (work/home/mobile delete as applicable) Preferred e-mail address I passed the Part 1 examination in (session) . I wish to submit (please tick as appropriate): a dissertation a casebook a PhD/MD thesis published papers. Specialty Number of words (dissertation or casebook only) (A dissertation should be between 4000 and 6000 words long, and a casebook between 10 000 and 20 000 words long, excluding bibliography and references see the relevant specialty regulations for more details) I intend to sit the Part 2 examination in: .. or I passed the Part 2 examination in: .. The appropriate application form and fee for the Part 2 examination must be submitted to the College before the relevant closing date. Please note that can be done before the project is approved (but your entry will remain provisional until it is approved) Declaration (Please tick each box below and sign and date the application form) % I enclose a current CV. % I have read and agree to abide by the Regulations & Guidelines for the College Examinations for Fellowship. % I agree, in the event of my admission to Fellowship, to obey the College regulations and to further to the best of my ability its objects and interest. % I am aware that my name and the title of my dissertation may be published on the College s website (not applicable for theses, casebooks or published papers). Signature ...........................................& & & & & .. Date ......................................................... SECTION B TO BE COMPLETED BY THE SPONSOR Sponsors are requested to comment on the candidates contribution to written options and, where published papers are submitted, multi-author works and his or her field(s) of study. Space is provided below for this purpose. More lengthy reports may be attached to the back of the form. Candidates name ........................... Date..... I hereby recommend .......................................s written project to be considered by the College. I confirm that I have read the Regulations and Guidelines for the College Examinations for Fellowship and to the best of my knowledge and belief he/she has fulfilled the requirements for submission of the written project and that the details given on the application form are correct. Sponsors signature Sponsors name: Address: Appointment: Sponsors should be Fello%&+,/9UVWXghk}ʻʻʻ֠֔uiu`N#h"&h"&CJOJQJ\^JaJh-uOJQJ\h&mhCJOJQJ^JhF7h&mhCJOJQJ^JhFhF5CJOJQJ^JhFCJOJQJ^Jh"&CJOJQJ^JhF7hML(CJOJQJ^JhLhML(CJOJQJ^JhML(CJOJQJ^JhF7h"&CJOJQJ^Jh";ch"&5CJOJQJ^Jh3h-uOJQJ-./89QRkd_$$Ifl40(l!f)4 laf4ytW~ ($IfgdML(?kd$$Ifl4(f)f)4 laf4ytW~ ($IfgdW~$a$ 9VXgh~{xkd$$Ifl4\(\ 2 f)4 laf4ytW~ ($IfgdW~a\\\TL$a$gd?$a$gdl>R$a$?kd$$Ifl4(f)f)4 laf4ytW~ ($IfgdW~RkdU$$Ifl40(l!f)4 laf4ytW~ # $ ԭxm]M;M"hl>Rh-u>*OJQJ\^JaJhl>Rh-u>*OJQJ^JaJhl>Rhl>R5OJQJ^JaJhU>*OJQJ^Jh4+?h4+?>*OJQJ^Jh'st>*OJQJ^Jhl>Rhl>R>*OJQJ^Jhl>Rhl>R5OJQJ^J(hl>Rh?5B*OJQJ^JaJph"h?5B*OJQJ^JaJph"hU5B*OJQJ^JaJph hl>Rhl>R#h zh-u5CJOJQJ^JaJ$ % c d e l m &$d%d&d'dNOPQgdn)$$d%d&d'dNOPQa$gdn$a$1$gd57$a$gdl>R$a$gd?$ % a b c d e  # I T U \ 望~jjU>,h"&hW~6B*CJOJQJ^JaJph)h zh-u6CJOJQJ\]^JaJ&h"&h-u6CJOJQJ]^JaJ)hW~h-u6CJOJQJ\]^JaJ,h"&h-u56CJOJQJ\]^JaJ,h"&hn56CJOJQJ\]^JaJ,hl>Rh z56CJOJQJ\]^JaJ,hl>Rh-u56CJOJQJ\]^JaJ h"&h-uCJOJQJ^JaJ\ ` l , / l m ̵̣zfzRfz;,h"&hn56CJOJQJ\]^JaJ&h"&hP;5CJOJQJ\^JaJ&h"&hP;56CJOJQJ^JaJ)h"&hP;56CJOJQJ\^JaJ&h"&h_36CJOJQJ\^JaJ#h[06CJOJQJ\]^JaJ,h;hD&56CJOJQJ\]^JaJ#hD&6CJOJQJ\]^JaJhW~6CJOJQJ^JaJ#h"&hW~6CJOJQJ^JaJm n o % & S T   > @ &'()$a$ (gdR0;gdP;m n o $ / 1 R T U b     % = ? @ J e l ǵۧۖۖzۖzlzۖzۖۖzۖzllۖzlh\CJOJQJ^JaJh~CJOJQJ^JaJhR0;CJOJQJ^JaJ h"&hnCJOJQJ^JaJhR=CJOJQJ^JaJ#h"&h-uCJOJQJ]^JaJ&h"&h-u5CJOJQJ\^JaJ h"&h-uCJOJQJ^JaJ&h"&hP;6CJOJQJ\^JaJ* %&'()XZkmvx´ ށjVEEEEE h"&h #CJOJQJ^JaJ&h"&h-u5CJOJQJ\^JaJ,h"&h-u56CJOJQJ\]^JaJh%emCJOJQJ^JaJ hU(6CJOJQJ]^JaJ&h"&h-u6CJOJQJ]^JaJh eCJOJQJ^JaJhU(CJOJQJ^JaJh~CJOJQJ^JaJ h"&hnCJOJQJ^JaJ h"&h-uCJOJQJ^JaJ)Xkv=>?@4Vx^`Vgd # $xa$gdi$a$ $ (a$gd #$a$$ & F a$ $ & F xa$$xa$>DIpdzǟdzdzzfUG6 h"&hrCJOJQJ^JaJhD&CJOJQJ^JaJ h"&h:oCJOJQJ^JaJ&h"&h-u6CJOJQJ]^JaJ&hBhT(6CJOJQJ]^JaJ hB6CJOJQJ]^JaJ&hBhB6CJOJQJ]^JaJ&hBh #6CJOJQJ]^JaJ&hBh-u6CJOJQJ]^JaJ&h"&h #6CJOJQJ]^JaJ h"&h-uCJOJQJ^JaJ<=v >?@KMf±p_H:h CJOJQJ^JaJ,h"&h-u56CJOJQJ\]^JaJ h"&hiCJOJQJ^JaJ h"&h PCJOJQJ^JaJhTN*CJOJQJ^JaJh1CJOJQJ^JaJ&h"&h-u6CJOJQJ]^JaJ hD&h-uCJOJQJ^JaJ h"&h-uCJOJQJ^JaJ h"&hD&CJOJQJ^JaJh-uCJOJQJ^JaJhD&CJOJQJ^JaJ4DKMNyz/0[\ 0*$gd95g$a$gd95g 00*$^`0 gdekgdek V^`VgdVx^`Vgd Vx^`VgdekfrBDJ, $?IKLNyӰӰ៍{l{XE$h"&h-u@CJOJQJ^JaJ'h"&h-u5@CJOJQJ^JaJhek5CJOJQJ^JaJ#h"&h P5CJOJQJ^JaJ#h"&h-u5CJOJQJ^JaJ h"&h:oCJOJQJ^JaJ#hph5CJOJQJ^JaJ h"&hCJOJQJ^JaJhCJOJQJ^JaJ h"&h-uCJOJQJ^JaJh#hCJOJQJ^JaJ 0*$ 0*$gd95g 0&d*$Pgd95gLs@@Ŵšq][U'h"&h:o>*@CJOJQJ^JaJhqzaCJOJQJ^JaJ h"&h:*CJOJQJ^JaJ h"&hrCJOJQJ^JaJ$h"&h-u@CJOJQJ^JaJ!h95g5@CJOJQJ^JaJ'h"&h-u5@CJOJQJ^JaJ'h"&h:o5@CJOJQJ^JaJ$h"&h:o@CJOJQJ^JaJ#@@@@@@@@gd k 0( &d*$Pgd:o 0( *$gd:ogdr 0*$ws of the College. In certain circumstances, and where such sponsorship is impracticable, the sponsor should be the head of department in which the applicant holds his or her present appointment.     1 @@@@@@@@@@@@@@@@@@@@@@@@@@̻ h kh kCJOJQJ^JaJhSh khzjhzUh-u@CJOJQJ^JaJhf @CJOJQJ^JaJ@@@@@@@@@@@@@@@@@@ 0*$$a$gd k1 0:p:*. A!"#T$O%1 ]$$If!vh#vf):V l4f)5f)/ 4f4ytW~k$$If!vh#v#vl!:V l4f)55l!/ 4f4ytW~$$If!vh#v#v\ #v#v2 :V l4f)55\ 552 / 4f4ytW~k$$If!vh#v#vl!:V l4f)55l!/ 4f4ytW~k$$If!vh#vf):V l4f)5f)/ / 4f4ytW~s02 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@_HmH nH sH tH ^`^ Normal$5$7$8$9DH$a$ @CJOJQJ_HmH sH tH H@H  Heading 1$$@&a$5>*OJQJPP  Heading 2$$@&a$5@CJOJQJ\@@@  Heading 3$$@&a$6]N@N  Heading 4$$ q*$@&a$5@F@F  Heading 5$@&5OJQJ\^JNN l>R Heading 7 <@&OJPJQJ^JaJDA D Default Paragraph FontVi@V  Table Normal :V 44 la (k (No List LBL  Body Text $9Da$5@CJOJQJ>P@> Body Text 2$a$5\BQB Body Text 3$a$ 6>*]T/!T l>RHeading 7 Char @CJOJPJQJ^JaJtH H2H %em Balloon TextCJOJQJ^JaJV/AV %emBalloon Text Char@CJOJQJ^JaJtH H/QH f Body Text Char5CJOJQJtH 4@b4  kHeader  B#B/qB  k Header Char@CJOJQJtH 4 @4  k0Footer  B#B/B  k0 Footer Char@CJOJQJtH PK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vc:E3v@P~Ds |w<v rF $ \ m f@@ !9m )4@@"@ @H 0(  0(  B S  ?VXY[\^_abps}9<@ N x { VXY[\^_abps33333333 UVVYYbms s BlrsCldҷc PRXB&rs:\rsk_rČI]_rs{rdҷBi{rspp^p`CJ OJQJo(q ^`OJQJo(o pp^p`OJ QJ o( @ @ ^@ `OJQJo( ^`OJQJo(o ^`OJ QJ o( ^`OJQJo( ^`OJQJo(o PP^P`OJ QJ o(h^`CJOJQJo(qh ^`OJQJo(oh pp^p`OJ QJ o(h @ @ ^@ `OJQJo(h ^`OJQJo(oh ^`OJ QJ o(h ^`OJQJo(h ^`OJQJo(oh PP^P`OJ QJ o(pp^p`CJOJQJo(q ^`OJQJo(o pp^p`OJ QJ o( @ @ ^@ `OJQJo( ^`OJQJo(o ^`OJ QJ o( ^`OJQJo( ^`OJQJo(o PP^P`OJ QJ o(pp^p`CJ OJQJo(q ^`OJQJo(o pp^p`OJ QJ o( @ @ ^@ `OJQJo( ^`OJQJo(o ^`OJ QJ o( ^`OJQJo( ^`OJQJo(o PP^P`OJ QJ o( ^`hH. ^`hH. pp^p`hH. @ @ ^@ `hH. ^`hH. ^`hH. ^`hH. ^`hH. PP^P`hH.h^`CJOJQJo(qh ^`OJQJo(oh pp^p`OJ QJ o(h @ @ ^@ `OJQJo(h ^`OJQJo(oh ^`OJ QJ o(h ^`OJQJo(h ^`OJQJo(oh PP^P`OJ QJ o(h^`OJPJQJ^Jo(h ^`OJQJo(oh pp^p`OJ QJ o(h @ @ ^@ `OJQJo(h ^`OJQJo(oh ^`OJ QJ o(h ^`OJQJo(h ^`OJQJo(oh PP^P`OJ QJ o(h^`CJOJ QJ o(qh ^`OJQJo(oh pp^p`OJ QJ o(h @ @ ^@ `OJQJo(h ^`OJQJo(oh ^`OJ QJ o(h ^`OJQJo(h ^`OJQJo(oh PP^P`OJ QJ o(h^`CJOJQJo(qh ^`OJQJo(oh pp^p`OJ QJ o(h @ @ ^@ `OJQJo(h ^`OJQJo(oh ^`OJ QJ o(h ^`OJQJo(h ^`OJQJo(oh PP^P`OJ QJ o(pp^p`CJOJQJo(q ^`OJQJo(o pp^p`OJ QJ o( @ @ ^@ `OJQJo( ^`OJQJo(o ^`OJ QJ o( ^`OJQJo( ^`OJQJo(o PP^P`OJ QJ o(h^`CJOJQJo(qh ^`OJQJo(oh pp^p`OJ QJ o(h @ @ ^@ `OJQJo(h ^`OJQJo(oh ^`OJ QJ o(h ^`OJQJo(h ^`OJQJo(oh PP^P`OJ QJ o( k_C{r:\DXB&I]_Bi{Bc   ^        B]        6                         Z        zGr                 Hܮ        6                 WDba9FU8\ i m6\z UT > ;f #D&ML(U(3)TN*[0_31w9R0;P;4+?@$AWF\FJCrK Pl>R% U/o[\^qza eGf95g=g#h&mhqicuipj%em'st`9w zW~)e57rS?R=p3HDB_lRhnT1(>-u k r~{_  s 9T(Up*:o|:*"&;ek(R=i?FVX@####@ r@,@@Unknown G.[x Times New Roman5Symbol3. .Cx ArialOSabonMalgun GothicYP CG TimesTimes New Roman7.*{$ Calibri5. .[`)Tahoma7. [ @Verdana?= .Cx Courier New;WingdingsA$BCambria Math"q7hVDkgm,gap p !xx24NN 3qHP?Rh2! xxV For office use:Marianne Whitelam Alison Mackay8         Oh+'0  8 D P \hpxFor office use:Marianne WhitelamNormalAlison Mackay6Microsoft Office Word@ @@bC@J[<p  ՜.+,0 hp   Royal College of PathologistsN For office use: Title  !"#%&'()*+-./0123456789:;<=>?@ABCDEFGHIJKLMNPQRSTUVXYZ[\]^abeRoot Entry Fpɇm<d@Data $1Table,DWordDocument 3FSummaryInformation(ODocumentSummaryInformation8WMsoDataStorepXm<pXm<YYLUN1G44V11==2pXm<pXm<Item  PropertiesUCompObj r   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q