RACP Foundation. Research Entry Scholarships. Application Form (Sample)

Transcription

1 RACP Foundation Research Entry Scholarships Application Form (Sample) Prior to completing the application form, applicants must: 1. Read the Terms and Conditions of the Award. If necessary, intending applicants may seek advice from a member of the assessing Committee, via the Senior Administration Officer, prior to submitting an application. 2. Assess their eligibility carefully- taking special note of where awards are tenable and the qualifications/research experience required for each award. Applicants may submit a research project for consideration for multiple individual awards within an award category, however multiple applications put forth for one award by the same applicant will not be considered. Applicants must submit an application on the online application form. Hard copies, pdf or word documents sent by will not be accepted. Applications must be submitted by the closing date. Please contact the Senior Administration Officer with application questions on or foundation@racp.edu.au

2 RACP Foundation Research Entry Scholarships Application Form (Sample) Section A Personal Details Full Name (including title) MIN Preferred Contact Number Preferred Status (Fellow / Trainee) Division/Faculty/Chapter Specialty Section B Project and Institution Details Project Title: Administering Institution Institution where research is being undertaken Commencement Date of Project Estimated Completion Date of Project Commencement Date for funding by an RACP Award Page 2 of 5

3 Section C Eligibility Are you currently enrolled in or about to enrol in PhD Masters by Research Other equivalent Research Higher Degree Consideration ment - Please list any factors that may have significantly interrupted your career Section D Awards applied for Please tick the award you are applying for and indicate why you consider you or your project is eligible Arnott Research Entry Scholarship in Cancer Research Basser Research Entry Scholarship Jacquot Research Entry Scholarships NZ Fellows Research Entry Scholarship RACP Australasian Chapter of Sexual Health Medicine Research Entry Scholarship RACP Fellows Research Entry Scholarship Vincent Fairfax Family Foundation Research Entry Scholarship Please list all other current and potential funding submissions which are external to the RACP and relevant to this application. List the name of award only. Section E Academic Qualifications Starting with the most recent, please list all university qualifications and post higher degrees, including the year of award and institution. Section F Career and Employment History Starting with the most recent, list your post graduate appointments, including the institution or company, the position held and the date, since graduation. Page 3 of 5

4 Please advise how you consider receiving funding through the RACP will assist/advance your career Section G - Research Involvement Please give details of your current research activities and details of any previous research experience. If possible give example(s) of how you have sought involvement in research and your role (Maximum 500 words) Provide details of all research or other awards previously or currently held and the role you held in the grant project (Maximum 100 words) Advise any noteworthy academic achievements in your career since graduation (Maximum 100 words) Starting with your most recent, please list the top five in ranking order, peer-reviewed full-length publications, and briefly state your role as an author on the publication. Please explain your contribution to the work reported in your top 5 publications. Briefly list other peer-reviewed full-length publications, published abstracts, letters or case reports in refereed papers. Section H Proposed Program Please provide a summary of the research proposal and include the rationale for the research along with a statement of purpose or research aims for scientific enquiry, hypothesis, new knowledge, technical advance and innovation Page 4 of 5

5 Research design and methods: Provide sufficient details for technical assessment of scientific protocol, feasibility and validity of data. This should include where appropriate: expected numbers, statistical power, and analysis plan and projected timelines. A qualitative study should include an explanation about the analytic approach to be used and the sampling methods proposed Research impact: Include the anticipated outcomes of the research, and comment on the extent of knowledge transfer that would occur as a result of the project (Maximum 500 words) Will ethics approval be required? If yes, has ethics approval already been attained? Research references relevant to the project (Maximum 30 references) Provide a budget for the project including a timetable indicating: i. how the RACP Award will be used; and ii. how any secured funding will be used. Please include the amount and the funding source (Maximum 400 words) If already receiving funding from the RACP please provide a progress report within the online template [FILE UPLOAD] Section I Certification I certify that the information supplied in this application is true and correct. I understand that the Royal Australasian College of Physicians may wish to verify this information with any institution or individual. I consent to such inquiries being made as part of the selection process. I have read the award terms and conditions and, if selected for an award, agree to abide by them. Certification Date: Page 5 of 5