Adelaide Summer Research Scholarship

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Adelaide Summer Research Scholarship 2017-18 These scholarships are open to continuing undergraduate students who wish to undertake a six week research project at the University of Adelaide over the 2017-18 summer vacation. Students who have completed at least two years of their program, at a standard acceptable level for admission to an Honours program, will be considered in the first instance. Students should ensure that an appropriate research project is available within their Faculty/School. In exceptional circumstances students who have completed less than two years of study may be considered. Students who are in receipt of, or expect to receive any other summer or vacation scholarships over the 2017-18 summer vacation (e.g. National Heart Foundation Summer Scholarship, Cancer Council Vacation scholarships) are not eligible for the Adelaide Summer Research Scholarships unless the other scholarship is for a separate research project. Each scholarship provides a living allowance of at least $200 per week for six weeks. The Scholarship must be taken up in the year at the time it is offered; acceptance of the Scholarship offer cannot be deferred. If a student declines the Scholarship offer, the Scholarship will be offered to the next eligible student. Applications for this scholarship close 5pm, Friday 6 October 2017. Please note only completed applications will be considered. Please ensure all signatures are provided before submitting.

Adelaide Summer Research Scholarship 2017-18 APPLICATION FORM This scholarship is available to continuing undergraduate students who wish to undertake a six week research project at the University of Adelaide over the 2017-18 summer vacation. Please read the attached flyer to ensure you are eligible to apply before completing the application. Scholarship applications close 5pm, Friday 6 October 2017. Personal Details Title: Family Name: Given Names: Mailing Address: State: Post Code: Phone/Mobile Number: Email Address: What is your date of birth?./ /.. Gender : M F Please supply your University of Adelaide Student Number: Are you: An Australian citizen An Australian Permanent Resident Other (Please see below) If you are not an Australian Citizen or permanent resident of Australia, do you have a current visa that extends beyond the end of February 2018? 2

University Study Details Which undergraduate program of study are you undertaking in 2017? (e.g. Bachelor of Arts) Which year of study are you undertaking in 2017? (e.g. Year 3) Have you received any other University prizes, awards or scholarships? If yes, please provide details: Have you applied for any other summer or vacation scholarships for the 2017-18 summer break? If yes, please provide details:....... te students who receive any other summer or vacation scholarships over the 2016/2017 summer break are not eligible to receive an Adelaide Summer Research Scholarship unless the other scholarship relates to a different research project. Have you or do you intend to apply for Honours at the University of Adelaide in 2018 (if applicable). Please indicate which Discipline/School Please give a brief outline of why you wish to undertake a research project at the University of Adelaide 3

` Supervisor/Project Details (to be completed by applicant & supervisor) School coordinating your project Name(s) of Academic staff member(s) with whom you will be working. Project title Brief description of project Name of Supervisor (please print) Position Held Supervisor s Signature Date Recommendation (to be completed by Head of Discipline or School) Name of Applicant: I hereby recommend this applicant for an Adelaide Summer Research Scholarship and confirm that this is a viable project for this applicant. Funding for the project is available for the period specified, and, I confirm that at least 50% of the living allowance will be met by the Faculty/School. Name of Head of School or Delegate: (please print) Position Held:.. Signature of Head of School or Delegate: Date:... 4

Payment Details (to be completed by Head of Discipline or School) The student will commence the six week research project on / / * Will the Faculty/School fund additional weeks beyond this six week period? YES NO If yes, how many additional weeks are to be funded? weeks. *Please note: this commencement date must be within the period from vember 2017 to mid-january 2018; Students are not able to undertake the project over the University Christmas/New Year closure period. Declaration (to be completed by applicant) I declare that the information I have supplied on this form is true and correct to the best of my knowledge. I understand that if I am awarded the scholarship and the University of Adelaide at any time thereafter forms the reasonable view that my application included false or misleading information or documentation, the scholarship may be cancelled by the University of Adelaide and any funds I have been paid must be refunded. I authorise the University of Adelaide to obtain such additional information deemed necessary to assess my application for this scholarship. I understand that the University of Adelaide will not disclose any information supplied on the application form or obtained for the selection process without written consent of the applicant. The information supplied will only be used for the selection process of this scholarship program and will be managed in accordance with the University of Adelaide Privacy Policy and Management Plan available at http://www.adelaide.edu.au/policies/62 I declare that I will notify the Coursework Scholarships Office in the event that I accept another summer or vacation scholarship over the 2017-18 summer break and that by this acceptance I am no longer eligible for an Adelaide Summer Research Scholarship unless the other scholarship relates to a different research project. Applicant signature: Date: If you have any questions about your application, please contact the Coursework Scholarships Office on (08) 8313 4224 or (08) 8313 6959, or email: courseworkscholarships@adelaide.edu.au Please forward the completed application form to: Coursework Scholarships Office C/- Ask Adelaide, Hub Central, Level 3 Blue Area, The University of Adelaide SA 5005 Closing date: 5pm, Friday 6 October 2017 5