application for the joyce thorpe nicholson fellowship

The University of Melbourne
APPLICATION FOR
THE JOYCE THORPE NICHOLSON FELLOWSHIP
Applications Close: Friday 31 July 2015
1. APPLICANT’S PERSONAL DETAILS
Title
Family Name
Given Name(s)
Date of Birth
Citizenship
Address
Telephone
Facsimile
E-mail Address
Current Position
2. PROJECT DETAILS
Please attach the following information:
ITEM
MATERIAL REQUIRED
1.
2.
3.
Project Title
Proposed Outcomes
Brief Summary
4.
Project Description
5.
Benefits of the Fellowship
6.
Timing
Title, 15 words or less, of the project to be carried out during the Fellowship
Please state in 50 words or less.
Summary statement, in ‘plain language’ suitable for general publicity and media
communication, of the aims and nature of the project and the expected benefits
of the Fellowship (Max 150 words)
Please describe your research or literary project overall, and in particular the work
to be carried out during the Fellowship, its aims, significance and the approach
(Max 600 words)
Please outline (a) why you have applied for the Fellowship, (b) how you feel it
would benefit your work (including what you would hope to achieve during the
Fellowship), and (c) the potential benefits to the University of Melbourne and the
Victorian public (Max. 400 words)
Please outline the expected dates of the Fellowship (note that the Fellowship is
awarded for periods between three and six months and must commence in the
2015 calendar year). (Max 100 words)
3. CURRICULUM VITAE
Please attach your current Curriculum Vitae (CV), including details of degrees and professional qualifications; academic,
professional, community and other positions held in the past ten years; and activities, achievements and awards relevant
to this application.
4. PUBLICATIONS
Please attach a list of publications, including public presentations.
Please include under a separate heading work that has been ‘accepted’ for publication or is ‘in press.’
5. REFEREES
Referees should be very familiar with your work and be able to comment on the Fellowship project and the likely benefits
of the Fellowship. It is strongly recommended that you provide your referees with a copy of your application.
Please give the names of the two people whom you have asked to submit referees’ reports.
NB. Referees’ reports are not sought directly by the Committee Secretariat. Applicants are responsible for ensuring that
three referees’ reports are submitted on time.
Name
Name
 Please ensure that you have given your referees a copy of The Joyce Thorpe Nicholson Fellowship Guidelines for Referees.
 Please ask your referees to ensure that their reports are received by Friday 31 July 2015
6. ADMINISTRATIVE INFORMATION
How did you first hear about this Fellowship? (please tick one)
Newspaper
advertisement
Media release
Internet search
Funding opportunities
database
Poster on department
noticeboard
From a colleague
From my thesis
supervisor
Other (please
describe)
7. DECLARATION
I declare that the information supplied by me on this form is complete, true and correct in every particular.
I acknowledge that the University may terminate a Fellowship if I have misrepresented my past and/or present
circumstances and that this termination may take place at any stage during any award.
Applicant’s signature
Date
ONE Application Form and supporting materials per Questions 2-4,
must be submitted by EMAIL to [email protected]
To be received no later than Friday 31 July 2015