Application Form

FACULTY OF HEALTH AND MEDICAL SCIENCES
LIONS MEDICAL RESEARCH FOUNDATION INC SCHOLARSHIP
GUIDELINES AND APPLICATION FORM
BACKGROUND
The Lions Medical Research Foundation Inc Scholarship is to support PhD students enrolled in the Faculty
of Health and Medical Sciences working in the areas of cardiovascular, cancer and chronic lifestyle
disease.
SELECTION CRITERIA
Selection will be made on the basis of academic merit, research potential and relevance of the research
relating to cardiovascular, cancer and chronic lifestyle disease.
The recipient of the scholarship(s) will be determined by a selection panel consisting of representatives
from the Faculty of Health and Medical Sciences Research Committee. The panel’s recommendations will
be submitted to the Lions Medical Research Foundation Inc for final approval.
If there are no candidates of sufficient merit in any given year, the scholarship(s) will not be awarded in that
year.
FINANCIAL SUPPORT
The scholarship(s) and its value are subject to the availability of funds. In the current round, up to $35,000
per annum will be available to be awarded at the discretion of the Lions Medical Research Foundation Inc
as either one full scholarship or top-up scholarships. In addition, the Lions Medical Research Foundation
Inc will consider awarding $2,000 per annum for approved expenses to attend international conferences.
The scholarship(s) are for 3 years with the possibility of a negotiated six month extension.
CONDITIONS
The recipient of the scholarship(s) will be expected to provide reasonable assistance in promoting the
research endeavours of the Faculty and to ensure all research undertaken during PhD candidature makes
reference to the Lions Medical Research Foundation Inc Scholarship.
HOW TO APPLY
Completed application forms and supporting documents should be forwarded electronically, in one pdf file,
to [email protected] by COB on Monday 19 June 2017.
FURTHER ENQUIRIES
Enquires should be directed to the Faculty of Health and Medical Sciences Research Education team at
[email protected]
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FACULTY OF HEALTH AND MEDICAL SCIENCES
THE LIONS MEDICAL RESEARCH FOUNDATION INC SCHOLARSHIP
APPLICATION FORM
SECTION A – TO BE COMPLETED BY THE STUDENT
1. STUDENT DETAILS
Title:
Surname:
Given names:
Email:
Telephone/mobile:
Student ID:
Date of PhD enrolment:
2. SUPERVISOR DETAILS
Title:
Surname:
Email:
Given names:
Telephone/mobile:
3. STUDY DETAILS
What is the title of your PhD project?
Please provide a brief description of your PhD project.
What is the relevance of the project to the research of cardiovascular, cancer or chronic lifestyle
disease?
Are you in receipt of any other scholarships related to your PhD research?
Yes ☐ No ☐
If yes, please give details:
4. SUPPORTING DOCUMENTATION
☐ Academic transcript*
*either copy of an original transcript or unofficial version printed from Access Adelaide
☐ Curriculum Vitae
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FACULTY OF HEALTH AND MEDICAL SCIENCES
5. APPLICANT SIGNATURE
I hereby apply for the Lions Medical Research Foundation Inc Scholarship in the Faculty of Health and
Medical Sciences and I declare that the information I have supplied is to the best of my knowledge
correct. I recognise that it is my responsibility to provide all necessary documentation and applications
with incomplete documentation cannot be considered.
Signature
Date
SECTION B – TO BE COMPLETED BY THE SUPERVISOR
Title:
Surname:
Given names:
FHMS School:
SUPERVISOR REPORT
Please provide a report illustrating the applicant’s suitability, competencies, skills and progress in the
areas of cardiovascular, cancer or chronic lifestyle disease to demonstrate commitment to the field.
What are the research achievements of the student so far? Why do you recommend this student for the
scholarship?
SUPERVISOR SIGNATURE
Signature
Date
Completed applications should be forwarded electronically, in one pdf file, by
COB on Monday 19 June 2017 to [email protected]
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