PhD Scholarship Application Form - lowitja.org.au€¦ · Web viewThis form has been prepared in...
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PhD Scholarship Application Form Applications have been extended. The closing date is Thursday 31 May 2018 (midnight AEST) INSTRUCTIONS Fill in this form Combine all supporting documentation into a single Word or PDF file To submit this application go to http://www.lowitja.org.au/starlight-scholarship o Complete the declaration on the website o Upload completed application form o Upload supporting documentation o Submit the Scholarship Application To guide this scholarship the Lowitja Institute has identified five key principles that underpin our approach to research. These are: 1. Beneficence – to act for the benefit of Aboriginal and Torres Strait Islander people in the conduct of our research 2. Leadership by Aboriginal and Torres Strait Islander people 3. Engagement of research end users (Aboriginal and Torres Strait Islander organisations and communities, policymakers, other potential research users) 4. Development of the Aboriginal and Torres Strait Islander research workforce, and The Lowitja Institute PhD Scholarship Application 2018 1
Transcript of PhD Scholarship Application Form - lowitja.org.au€¦ · Web viewThis form has been prepared in...
PhD Scholarship Application Form
Applications have been extended. The closing date is Thursday 31 May 2018 (midnight AEST)
INSTRUCTIONS
Fill in this form Combine all supporting documentation into a single Word or PDF file To submit this application go to http://www.lowitja.org.au/starlight-scholarship
o Complete the declaration on the websiteo Upload completed application formo Upload supporting documentationo Submit the Scholarship Application
To guide this scholarship the Lowitja Institute has identified five key principles that underpin our approach to research. These are:
1. Beneficence – to act for the benefit of Aboriginal and Torres Strait Islander people in the conduct of our research
2. Leadership by Aboriginal and Torres Strait Islander people3. Engagement of research end users (Aboriginal and Torres Strait Islander organisations and
communities, policymakers, other potential research users)4. Development of the Aboriginal and Torres Strait Islander research workforce, and5. Measurement of impact in improving Aboriginal and Torres Strait Islander people’s health.
No late or incomplete applications will be accepted; extension of time will not be granted. It is the applicant’s responsibility to submit their application by the due date. Applicants will receive an auto-generated email following submission. If this is not received within 24 hours, contact Jessie Motlik on 03 8341 5515 [email protected] or Dr Shayne Bellingham on 03 8341 5516 [email protected]
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APPLICATION FORM
This form has been prepared in MS Word, using a table format that will expand as content is inserted. Please do not delete or re-format any of the content such as questions or instructions.
Please comply with the word limits. Applications not complying with the word limits may not be considered. Text should be 12 point and the font Calibri.
Please note that, if you do not complete all relevant sections of this application or do not supply all the requested supporting documentation it will not be possible for the Lowitja Institute to process your scholarship application.
Application code [Lowitja Institute to insert]
Contact details
Title
First name
Last name
Date of birth
Phone
Mobile
Student email
Personal email
Home address
Postal Address
Aboriginality☐ Aboriginal ☐ Torres Strait Islander ☐ Both
Proof of Aboriginality may be required if your application is successful
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Enrolment details Evidence of your enrolment will be required if offered a scholarship
Name of enrolling university
Campus location
Faculty/School
Title of enrolling PhD program
PhD commencement date
Proposed PhD completion date
Name of primary supervisor
Institution & campus
Phone
Mobile
Name of secondary supervisor
Institution & campus
Phone
Mobile
Include written confirmation from each supervisor in your supporting documentation.
Administering institution Insert name of scholarship funds administering institution if different from university of enrolment.
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Supporting academic information
QualificationsAttach official documentation of your recent academic qualification/s – Institution, award, year, etc.
Curriculum VitaeAttach a CV, maximum of 4 A4 pages
Academic RefereesAttach two academic references in support of your PhD research and scholarship application
Supporting Aboriginal and Torres Strait Islander Researchers
Research activity details
Other financial supportProvide the details of any other financial support you have applied for or have received
☐ Yes – I have applied for or have received other financial support
☐ No - I have not applied for or have received other financial support
Lowitja Institute program areas – proposed research best fits in which program area?You may select more than one program area.
☐ Community capability and the social determinants of health
☐ Needs and opportunities for the Aboriginal and Torres Strait Islander health workforce
☐ Health and policy systems
Research activity title (maximum 20 words)
INSERT YOUR TEXT HERE
The Lowitja Institute PhD Scholarship Application 2018
Academic supervisors experience in leadership, supervision and capacity building of Aboriginal and Torres Strait Islander students? (Maximum 300 words)Outline the experience of academic supervisors in best practice supervision of Aboriginal and Torres Strait Islander people students.INSERT YOUR TEXT HERE
Academics supervisors experience in conducting research with Aboriginal and/or Torres Strait Islander people and organisations in an ethical way? (Maximum 300 words)INSERT YOUR TEXT HERE
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Research activity or question (maximum 100 words)
Briefly outline, in plain English, the central activity or research question of your PhD
INSERT YOUR TEXT HERE
Detailed research activity description – technical (maximum 1000 words)
Provide a detailed outline of the PhD research including details of the methodology, data collection and analysis, and the evaluation and impact measurement of the research. INSERT YOUR TEXT HERE
EthicsThe Lowitja Institute is committed to the highest standards of integrity in research practice. As the national institute for Aboriginal and Torres Strait Islander health research, and being an Aboriginal and Torres Strait Islander organisation, it is incumbent upon us to demonstrate what integrity in research practice, and ethics, means for Aboriginal and Torres Strait Islander health research. The five principles that underpin the Lowitja Institute’s approach to ethical research are:
1. Benefit for Aboriginal and Torres Strait Islander people2. Leadership by Aboriginal and Torres Strait Islander people3. Engagement of research end users (Aboriginal and Torres Strait Islander organisations and
communities, policy makers, other potential research users) 4. Development of the Aboriginal and Torres Strait Islander research workforce, and5. Measurement of impact in improving Aboriginal and Torres Strait Islander people’s health.
This means that Aboriginal and Torres Strait Islander people must be meaningfully involved in the research and requires people to work together in genuine, transparent and mutually respectful partnerships. A Lowitja Institute Scholarship recipient’s PhD research will be required to demonstrate sound ethics practice. This process should be informed by:
National Statement on Ethical Conduct in Human Research 2007 www.nhmrc.gov.au/guidelines-publications/e72
Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research and the Guidelines for Ethical Research in Indigenous Studies www.nhmrc.gov.au/guidelines-publications/e52
Keeping Research on Track: A guide for Aboriginal and Torres Strait Islander peoples about health research ethics www.nhmrc.gov.au/guidelines-publications/e65
Resources to support ethical practice can be found at the Lowitja Institute Ethics Hub at: www.lowitja.org.au/ethics.
How will Aboriginal and Torres Strait Islander people be involved in your research? (Maximum 300 words)Outline the proposed involvement of Aboriginal and Torres Strait Islander people including academic leadership, community leadership and community organisations in the research.
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INSERT YOUR TEXT HERE
Will your research require ethics approval?
☐ No – my PhD research will not require any ethics approval☐ Yes – my PhD research will require any ethics approval
If Yes, outline the ethical approval process required for your research? (Maximum 300 words)
INSERT YOUR TEXT HERE
Knowledge exchange and research translationThe Lowitja Institute considers it is vitally important that our investment in research results in lasting positive impact on the health and wellbeing of Aboriginal and Torres Strait Islander people. Knowledge exchange refers to the process of mutual two-way learning between the research and those engaged in the research project. Research translation refers to the identification and facilitation of policy and/or practice outcomes based on the evidence generated through research. Our knowledge exchange approach is outlined on the Lowitja Institute website at www.lowitja.org.au/knowledge-exchange .
How will your PhD research contribute to knowledge exchange and knowledge translation during and as a result of your research? (Maximum 300 words)Please consider the knowledge generated by your research activities and how these may be applied or engage others during your research and PhD program; and the development of any tools and resources; means of disseminating and publishing research findings; and any other activities for knowledge exchange.
INSERT YOUR TEXT HERE
Research benefitThe Lowitja Institute aims to work collaboratively with researchers to enable maximum benefit to Aboriginal and Torres Strait Islander people and communities from the research effort. The Institute is supporting development of tools and methodologies to assess the impact and benefit of research.
What do you perceive the likely benefits in health and wellbeing for Aboriginal and Torres Strait Islander people will be as a result of your research? (Maximum 200 words)
INSERT YOUR TEXT HERE
Intellectual propertyThe Lowitja Institute recognises the fundamental importance of identifying and classifying intellectual property (IP) developed from research activities funded by the Lowitja Institute, as well as protecting background IP provided to research activities by Aboriginal and Torres Strait Islander people along with that of other participants in research collaborations. Applicants should be aware that, if they are successful in obtaining funding for their PhD research, IP will be discussed and negotiated to achieve an equitable outcome for all parties as part of the Institute’s general research funding agreement negotiations. If you require advice please contact, Jessie Motlik on 03 8341 5515 [email protected] or Dr Shayne Bellingham on t: 03 8341 5516 [email protected].
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Is there any background IP to be brought to your PhD research? Background IP is IP that was developed before the research commenced and that you will use in your research. Please identify any background IP that you will bring to your research. (Maximum 200 words)
INSERT YOUR TEXT HERE
Applicant’s declaration
Please complete this declaration as well as the online declaration when you submit this application.
I declare that the information supplied in this application is true and correct and that the listed supporting documents have been supplied. I have original copies of all submitted documents and I understand that the Lowitja Institute may request sighting the original documents for the purpose of verification. I acknowledge that all documents submitted will become the property of the Lowitja Institute and, as such, will not be returned to me.
Yes / No
I understand that the information collected in this application form will enable the Lowitja Institute to assess my application and, if my application is successful, create a legally binding Scholarship Agreement. I also understand that if I do not complete all relevant sections of this application or fail to supply all supporting documentation my application will not proceed.
Yes / No
I understand that it is a serious offence under the Criminal Code of the Australian Commonwealth to give misleading or false information and I acknowledge that the Lowitja Institute reserves the right to reverse any decision made about my scholarship application funding if it is found that I have provided misleading or false information.
Yes / No
Name
University of enrolment/intended enrolment
Administering institutionif different from university of enrolment
Date
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Supporting documentation checklistEnsure all supporting documentation meets the requirements of the application and correspondence from an institution must be on official letterhead. Allow sufficient time to obtain or prepare your supporting documentation:
1. Evidence of your enrolment (if available or can be submitted when requested)2. Written confirmation of supervision from experienced primary and secondary PhD
supervisors 3. Academic qualifications – official evidence of your current educational qualification/s 4. Curriculum Vitae (maximum of 4 A4 pages)5. Two academic references6. Details of any other financial support you have applied for and/or have received.
Submitting the supporting documentation
All supporting documents must be combined into a single Word or PDF file (i.e. only one attachment is allowed)
PLEASE UPLOAD the supporting document file at
http://www.lowitja.org.au/starlight-scholarship
Receipt of application
Applicants will receive an auto-generated email following the submission of an application.
If you do not receive this email within 24 hours, please contact Jessie Motlik on 03 8341 5515 [email protected] or Dr Shayne Bellingham on 03 8341 5516 [email protected]
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