COLLEGE OF ARTS AND SOCIAL SCIENCES Humanities Research Centre Research School of Humanities and the Arts Visiting Fellowship Application: 2016 Deadline: 30 April 2015 PERSONAL PARTICULARS Title Given Names Surname: M Country of Citizenship F Date of Birth BUSINESS MAILING ADDRESS Department Institution Town/City Country Postcode/Zipcode PERSONAL MAILING ADDRESS No/Street Town/City Country Postcode/Zipcode Email address Telephone Day Evening Mobile Fax Current Appointment FELLOWSHIP CATEGORY (tick) Visiting Fellow - Grant Visiting Fellow - Partial Grant Visiting Fellow - No Grant Visiting Fellow – Gender Institute PROPOSED DURATION OF VISIT (February 2016 to December 2016 – maximum period = 60 days) From: To: HAVE YOU PREVIOUSLY BEEN A VISITOR TO AUSTRALIA (tick) Yes No HAVE YOU PREVIOUSLY BEEN A VISITOR AT THE ANU (tick) Yes No If yes please provide details Date(s) HRC VF 2016 Application Form Capacity P. 1 COLLEGE OF ARTS AND SOCIAL SCIENCES RESEARCH PROJECT TITLE Provide a detailed Research Proposal ATTACHMENT A Do you consider you Research Project fits within the Annual Theme? Yes No APPLICATION ACCOMPANIED BY Current Curriculum Vitae (including a list of publications) Yes Yes No No Attached CONTRIBUTION TO THE HRC AND THE AUSTRALIAN NATIONAL UNIVERSITY PROGRAMS Please select categories to which you are willing to contribute Work-in-Progress Presentation at Workshop Conference or Symposium participation Graduate Master Class CONTRIBUTION TO OTHER AUSTRALIAN UNIVERSITIES AND TO AUSTRALIAN PUBLIC LIFE Please select categories to which you are willing to contribute Presentation at Festival or public event Public Lecture Conference or Symposium participation Graduate Master Class ACCOMPANYING FAMILY MEMBERS Are family members accompanying the Visitor Name: Relationship DOB: Yes Passport Number: No Birth Country: HOW DID YOU HEAR ABOUT THE HRC VISITING FELLOWSHIP PROGRAM? (tick) HRC Website advertisement Flyer Email Friend Newspaper (which one?) Other (details) REFEREES (Names of three referees) Referee’s Name Position/Appointment Relationship to Applicant Email address Referee’s Name Position/Appointment Relationship to Applicant Email address HRC VF 2016 Application Form P. 2 COLLEGE OF ARTS AND SOCIAL SCIENCES Referee’s Name Position/Appointment Relationship to Applicant Email address APPLICANT’S SIGNATORY Name Signature Date Please post or email the application to: Professor Will Christie Head, Humanities Research Centre Research School of Humanities and the Arts A.D Hope Building #14 Ellery Crescent The Australian National University Canberra, ACT, 0200 Australia or E: [email protected] Attachment A RESEARCH PROPOSAL Please detail the research to be undertaken during your visit to the Humanities Research Centre at the ANU (800 word limit) In your proposal, please include reference to: (a) the innovation and scholarly significance of the project (b) its links to the HRC’s annual theme (c) any research interests connected with work being undertaken in the HRC and/or the ANU more generally HRC VF 2016 Application Form P. 3
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