BLODWEN JERMAN PRIZE

DISSERTATION ENTRY FORM


NAME OF CANDIDATE ……………………………………..

CANDIDATE’S HOME ADDRESS …………………………

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HIGHER EDUCATION INSTITUTE TO WHICH CANDIDATE IS OR WAS ATTACHED (with Address)

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DEGREE FOR WHICH DISSERTATION WAS SUBMITTED

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DATE DEGREE WAS AWARDED …………………………

TITLE OF DISSERTATION ……………………………….

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This form should be accompanied by the required certification, signed and including contactable address.

Please return completed application to:

Professor Muriel Chamberlain, Department of History, Swansea University, Singleton Park, Swansea SA2 8PP