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