Application Form

VICE-CHANCELLOR’S POSTDOCTORAL FELLOWSHIP PROGRAMME
Contact person:
Ms Mpho Maithufi
Email: [email protected]
Tel: 012 420 4023
PARTICULARS OF PROPOSED FELLOW
Title, initials and surname:
Most recent institution affiliated with:
Highest qualification:
Date on which the highest qualification was obtained:
Institution that awarded the highest qualification:
EXPECTED PERIOD OF SUPPORT
From…………………….. To ……………………….
RESEARCH PROGRAMME OR THEME, INSTITUTE, CENTRE OR DISCIPLINE APPLICABLE TO
APPLICATION:
PROPOSED RESEARCH FOCUS (IF KNOWN)
Not more than 2 pages.
PROPOSED SUPERVISOR/MENTOR (IF KNOWN)
MOTIVATION:
Your research achievements, expertise and objectives related to this application.
Length: not more than two pages
DECLARATION BY THE APPLICANT
I certify that the information in this form is correct and that if I am awarded a postdoctoral fellowship, I shall follow
the recommended guidelines stipulated in the Constitution of the Postdoctoral Fellowship Programme.
SIGNATURE: ………………………………………………
(Electronic signature accepted)
DATE: ………………………………………………………
1
Appendix 1
UP POSTDOCTORAL FELLOWSHIP PROGRAMME
(FORMAT FOR SUBMISSION OF CV FOR PD FELLOWSHIP)
DATE OF SUBMISSION:
1. BIOGRAPHICAL SKETCH
1.1 GENERAL INFORMATION
Maiden
name (if
applicable)
Surname:
First names:
Title:
Date of birth:
Gender:
Citizenship:
Age:
Email address:
Institution most
recently affiliated
with:
Position:
Postal address:
Telephone number:
Fax number:
2
ACADEMIC QUALIFICATIONS OBTAINED (List all)
Degree/
Diploma
Field of study
HE institution
Year
obtained
Distinctions
RESEARCH / RELEVANT WORK EXPERIENCE TO DATE (if applicable)
Name of institution
Capacity and/or type of work
Period
2. RESEARCH OUTPUT (Please attach and ensure appropriate referencing)
Publications in peer-reviewed/refereed journals
Publications in peer-reviewed/refereed journals (submitted)
Books and/or chapters in books
Published full-length conference papers/keynote addresses
Non-refereed scientific publications or popular scientific articles
Technical/policy reports
Patents
3
3. OTHER SCHOLARLY, RESEARCH-BASED CONTRIBUTIONS
Participation in conferences, workshops and short courses
(Specify type of contribution.)
Teamwork and collaboration with others
Membership of national and international bodies
(List all the scientific associations or societies to which you belong. Specify your involvement.)
Visits as a researcher to universities or research institutions
4. BRIEF STATEMENT OF MAJOR SCHOLARLY CONTRIBUTION FROM PHD (MAX 500 WORDS)
……………………………………………………….
Signature
Date
………………………………………………..
4
Appendix 2
LETTERS OF REFERENCE
Provide at least two letters of reference from academic sources (e.g. the candidate’s doctoral supervisor; preferably at least one
must be from an external source).
The referee should forward the confidential letter directly to [email protected], with the applicant name in the subject line.
Format: Letters of Reference
Name of postdoctoral fellow:
(To be completed by the applicant)
Description of the research field:
(To be completed by the applicant)
Name:
(To be completed by the referee)
Institution:
(To be completed by the referee)
Association with postdoctoral fellow:
(To be completed by the referee)
Evaluation of the relevance and suitability of the fellow’s research experience to the proposed project:
(To be completed by the referee)
Comments on the intellectual capabilities, skills and expertise the fellow will bring to the UP team:
(To be completed by the referee)
…………………………
Signature: Referee
…………………………
Date
5