AMPLIFY FESTIVAL 2015 BRIGHT SPARKS ENTRY FORM 1 2 About you About your project 3 Your supporting evidence ABOUT YOU: Describe yourself in the length of a tweet: (140 characters) * Maximum Allowed: 140 characters. Contact Details: Title * Name * First Last Position * Institution or Organisation: * Phone Number (work) * Mobile Number * Email * Twitter* Bright Sparks Application Form Page 1 of 6 Address * Street Address Address Line 2 City State Code Country Your Qualifications: (e.g. Bachelor of Medical Science - University of Sydney, 2009) Qualification 1: * Qualification 2: * Qualification 3: * Next Page Bright Sparks Application Form Page 2 of 6 ABOUT YOUR PROJECT: This entire section plays a vital role in assessing your application. We want to see if you can describe your work and communicate its relevance using everyday language to a lay audience. Avoid complex terminology / jargon – i.e. imagine you are explaining what you do to a stranger you just met at a BBQ Project Title/Tagline: *Think newspaper headline (less than 8 words) Project Summary in Basic Layman Terms: This is a vital section of the application assessment criteria –briefly tell us about your project or idea. Inspire us with your story and spark our curiosity to read on for further details. * * field (less than 100 words) Project Description: (overall less than 300 words) What are you trying to achieve or your current results? * field (less than 100 words) Why does your research matter? Why it is relevant to a general or business audience and why should we care? * field (less than 100 words) How will your research transform or benefit society? * field (less than 100 words) Next Page Bright Sparks Application Form Page 3 of 6 Show Your Supporting Documentation (and attachments) Please provide evidence of internal/external review to support your application. This may be from your PhD supervisory panel/ higher degree research coordinator/ Chief Executive or GM of your organisation. You will be asked to upload your evidence as a single document at the end of this form. Evidence of Peer Review: Briefly list the types of evidence you will attach in support of your application. e.g. Certificate of candidature Conference papers/presentations Publications submitted or in press Patents Research awards Internal reviews by academic staff Maximum Allowed: 300 characters. Please upload your supporting evidence as a single document * BROWSE Publications/Papers: List titles of any recent and relevant publications (including those submitted or in press), conference presentations etc Author/s (Year). Name of Paper, Tile of Publication, Relevant Pages Author/s (Date &Year). Title of Paper. Name of Conference, Venue Publications/Paper 1: Publications/Paper 2: Publications/Paper 3: Publications/Paper 4: Bright Sparks Application Form Page 4 of 6 Referees: Please provide the contact details of at least 2 referees who can verify details of your enrolment and the scientific rigor of your project (e.g. your PhD supervisor/s, employer if they are sponsoring your research etc.) Referee Name 1 * First Last Position * Institution or Organisation: * Phone Number (work) * Email * Referee Name 2 * First Last Position * Institution or Organisation: * Phone Number (work) * Email * Bright Sparks Application Form Page 5 of 6 Collaborators: List any individuals or organisations who need to be acknowledged? Collaborator Name 1 * First Last Institution or Organisation: * Collaborator Name 2 * First Last Institution or Organisation: * Personal Authorisation I have read and understood the terms and conditions of participation and wish to submit an application for review. I am willing to commit to, and actively participate in, the required training and performance dates. Submit Bright Sparks Application Form Page 6 of 6
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