Higher Degree Research International Students Scholarship Application Form Please refer to the International Students Scholarship Application Guidelines when completing this form Application Type UNE International Postgraduate Research Award (UNE IPRA) Other: (Please provide the full name of the scholarship you are applying for) Personal Details Title: i.e Dr, Mr, Mrs, Ms, Miss Family name: Date of Birth: Given name(s): Gender Day / Month / Year Male: Female: (please tick appropriate box) Please write your UNE Student ID Number (if known) Current Mailing Address: Full Address: Country: Post Code: Email: Telephone: Mobile: Permanent Address in Home Country (if different from current mailing address): Full Address: Country: Post Code: Email: Telephone: Mobile: Special Needs Do you have any special needs or considerations that we should know about? Yes: (Please attach further information indicating any special assistance you may require, if applicable) No: Citizenship Please note: Australian and New Zealand citizens and Australian Permanent Residents should not be using this form Citizenship / Country of Passport: Country of Permanent Residence: Passport Number: Visa Number: Diplomatic Visa Type: Dependent Student Other (please specify) Candidature Details Candidature Offer at UNE Have you already been offered a place or commenced study in a Higher Degree Research (HDR) program at UNE? Yes No * *If NO, have you made an application for HDR Candidature at UNE? Yes No * *NB: To be eligible all scholarship applicants must have applied for HDR Candidature at UNE Higher Degree Research (HDR) Candidature Application details: HDR Course Name (eg Doctor of Philosophy): School (eg School of Science and Technology) Principal Supervisor: Co-Supervisor(s): Mode of Study: Full-Time On-Campus Student Research Proposal Please outline the general area of research you wish to study and provide a brief description (minimum 100 words, maximum 150 words) Title: Description: UNE – HDR International Student Scholarship Application Form Current Study Are you currently studying at an institution other than UNE? Yes No If you are currently studying at an institution other than UNE, please provide details as requested below Name of Course of Study Institution Anticipated completion date Transfer Are you applying to transfer your candidature and scholarship from another institution? Yes No If you are applying to transfer your scholarship with masters or doctoral research candidature from another institution, please provide details as requested below Current Scholarship & HDR Candidature Details Date commenced: Scholarship: Course of Study: Institution: (Please provide certified proof of your scholarship commencement date, as well as intermissions or changes of HDR Scholarship and Candidature status that may have occurred during your candidature) Other Finance for Study Previous and Current Australian Government Postgraduate Scholarships (or any other Postgraduate Scholarships) List all PREVIOUS and CURRENT Postgraduate Scholarships that you have held: Duration Name of Award Start Date End Date Institution Value of scholarship Current Applications for Scholarships or for Sponsorship Are you applying for, or have you arranged any other externally funded Scholarships or Sponsorship? Yes No UNE – HDR International Student Scholarship Application Form If ‘yes’, and you have already received a Scholarship or arranged Sponsorship, please provide the following details: Tuition Fees Living Expenses Value of Living Expenses: (per year in AUD) $ Please provide the name of the Scholarship or Sponsor (i.e Government sponsor): Are any other benefits included? (please specify): Academic Qualifications and Awards Previous Qualifications List below ALL tertiary level studies Degree or Qualification Institution and country Date completed/ Expected date of completion Proportion of Research Grade, Result or GPA Language of instruction Awards Achieved During Previous Study Have you received any academic awards during previous study, i.e University Medal? Yes No Please list the Awards you have received with information about the award (if insufficient space, please attach further information) UNE – HDR International Student Scholarship Application Form Research and Relevant Experience Postgraduate Research Experience (Past Five Years Only) Please describe briefly any postgraduate research experience you have had over the last years (if insufficient space, please attach further information – page maximum) Employment History (Past Years Only) Please detail any relevant work experience (if insufficient space, please attach further information – page maximum) Name of employer Your duties/position Dates Publications Please list your top publications (if insufficient space, please attach further information) DO NOT provide copies of publications For example: Smith J., Brown S., Shaw P “Title”, Name of Publication, Type of Publication, (e.g., refereed journal article, non- refereed journal article, book chapter, review etc.), Publication Details (e.g., Volume 29, issue 2, 2005) (If insufficient space, please attach further information – page maximum) Author(s) Title of Publication Type of Publication Publication Details Non Traditional Research Outputs Please list your top non-traditional research outputs such as original creative works, live performance of creative works, recorded/rendered creative works and substantial public exhibitions and events Creative work Documentation Original artwork Original music (includes notated and/or improvised music for any medium UNE – HDR International Student Scholarship Application Form Original theatre performance / production, original script for performance Original performed choreography / production Screening of original film work including documentaries Publication of a piece of creative writing Environmental design (for architect, landscape architect, urban designer) Performance of music, theatre, dance, film Academic Referee Reports All applicants must organise two Academic Referee Reports Applicants must also provide contact details of their referees on this application form and ask the referees to submit their written reports directly to the University on the Referee’s Report Form which can be downloaded from the UNE website available at: https://www.une.edu.au/research/hdr/hdrformsandpolicies/hdr-referee-report Referee Referee Name Position Institution Postal address Telephone/mob Facsimile E-mail Statement of Support from Supervisor All applicants must organise a Statement of Support from their proposed Principal Supervisor This statement should be no more than 500 words The Statement of Support should outline alignment of the applicant’s research proposal with the School research priorities and provide a clear indication of the level of support of the student’s project If it is applicable this Statement of Support should clearly state if the student’s study will be part of an external grant and/or other external project or partnership It is the applicant’s responsibility to ensure that this Statement is submitted to the University by the closing date of the scholarship round so it can be considered with the scholarship application There is no specific form and the Statement of Support can either be submitted direct to Research Services by the Supervisor via email to hdrdocuments@une.edu.au or it may be supplied by the Supervisor to the student for attachment to this application Please note the University will not request this statement on your behalf UNE – HDR International Student Scholarship Application Form 10 Declaration Giving false or misleading information is a serious offence under the Criminal Code (Australian Commonwealth) • I declare that I have read and understood the questions on this form and that the information I have supplied on this form is correct and complete • I understand that the University may vary or cancel any decision made on the basis of incorrect or incomplete information provided by my referees or me If any information is discovered to be untrue or misleading in any respect I consent to the University collecting, storing and disclosing this information to Universities Australia and Universities Australia member institutions, the Australasian Conference of Tertiary Admissions Centres (ACTAC), and any other relevant authority I agree to immediately advise the UNE International Precinct of any changes to the information provided on this form; I authorise UNE to obtain official records and results from any previous educational institutions I have attended; I agree to abide by the University of New England’s Conditions of Award and Conditions of Scholarship which may be amended from time to time by the University I understand that UNE may make available to Commonwealth and State Government agencies any information provided by me, pursuant to obligations under the ESOS Act and 2007 National Code I understand that giving false or misleading information is a serious offence under the Criminal Code (Australian Commonwealth) • • • • • • Please sign and date this application below before printing, scanning and returning to us electronically or mailing to us Your application will not be processed if it has not been signed below Signed Date / / Applications may be submitted online, by mail or by fax Online: Mail: Via the AskUNE website Research Services Directorate TC Lamble Administration Building http://yourfutureaskune.custhelp.com/app/utils/login_form/redirect/ask University of New England Armidale NSW 2351 Australia Fax: + 61 6773 3543 Scholarship enquiries should be directed to Research Services (contact details below) Research Services Phone: + 61 6773 3715 Fax: + 61 6773 3543 https://hdr.custhelp.com/ UNE – HDR International Student Scholarship Application Form UNE CRICOS Provider Number 00003G UNE – HDR International Student Scholarship Application Form