FELLOWSHIP
APPLICATION
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Approved
Declined
............................................... / /
(Director)
(Date)
Notified .....................................................
NB: Please read the Guidelines for Eligibility before completing this form
Applicant/s
Applicant 1
Courtesy Title *
First Name *
Last Name *
Please select
Telephone No. *
Email *
CSU ID *
Section/Location *
Please select
Applicant 2
Courtesy Title *
First Name *
Last Name *
Please select
Telephone No. *
Email *
CSU ID *
Section/Location *
Please select
Applicant 3
Courtesy Title *
First Name *
Please select
Telephone No. *
Email *
CSU ID *
Section/Location *
Please select
Last Name *
*denotes Required Field
Fellowship Candidate Details
Courtesy Title *
First Name *
Last Name *
Please select
Telephone No. *
Email *
Attached is a copy of the candidates CV
Yes
No
Attached is a copy of a letter of support from the candidates’ workplace
Yes
No
Proposed dates the candidate will be located at NWGIC (please enter below);
Commencement Date:
Completion Date:
Alignment with National Wine and Grape Industry Centre Platforms and Research Priorities
Which of the following research priority areas does the project relate to and to what extent?*
Vine Health and Diseases
Vine Physiology (source sink relationships; root functioning, flowering and berry growth)
Fruit and Wine Composition, Chemistry
Wine making, wine styles and consumer preferences
Decision making tools; remote sensing; modelling, processes
Other (please specify)
Project Details
Please provide proposed project details during the fellowship – include project description/linkage to existing
NWGIC projects/proposed research.
Project Details - continued
Please provide proposed project details during the fellowship – include project description/linkage to existing
NWGIC projects/proposed research – continued.
Project Communication and output plan
Please provide details of the manner in which outputs from the fellowship will be communicated to Centre
Members (NWGIC) and the Australian Wine Industry.
Outcomes
Linkage with Industry
Project dates
Budget:
Living expenses
Travel
Consumables relating to project
Other related information
Linkage with NWGIC Higher Degree Students – Summarise how the proposed Fellow will be involved with
supervision and guidance of existing NWFIC Postgraduate students.
Declaration
In making this application I declare (by ticking the box provided) that:
•
I have read, understood and agree to the information and conditions described in the Honours
Scholarship.
•
To the best of my knowledge, all information provided in this application is true and correct and no
information is false or misleading.
I agree*
Name*
Date*
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