Edith Jessie Carnell Entry Form

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EDITH JESSIE CARNELL
TRAVELLING SCHOLARSHIP
Established as a result of a bequest in the will of Mr Archibald George William Dunningham,
the Edith Jessie Carnell Travelling Scholarship is named in honour of Edith Jessie Carnell, a
British Librarian who worked in New Zealand between 1939-1944 as liaison between the NZ
Library Association and the Country Library Service.
The scholarship is available for the purpose of assisting a librarian to further professional
development by travelling anywhere in the world for either research, a study visit or
conference attendance.
The award consists of the grant and a citation. These will be presented at the annual LIANZA
Conference.
1.
Name of Applicant:
____________________________________________________________________
2.
Current Library Position:
____________________________________________________________________
3.
Address:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
4.
Current LIANZA Membership no.: _____________
Please note you must be a current personal member engaged in Library or
information work with a minimum of 5 years experience.
6.
Phone: ______________________________
Email: _______________________________
Rev11/12
7.
Please advise the names, address, email and contact numbers of two referees
(1)
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Phone:__________________________Email: _______________________________
(2)
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Phone:__________________________Email: _______________________________
8.
State your professional aim for the travel:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
9.
Write an outline of your course of study, research, purpose for attending the
conference:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Rev11/12
10.
Provide a plan and time-frame for dissemination of the results of the research or
study :
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
Signature ________________________________ Date: ______________________
Send entries to:
Edith Jessie Carnell Travelling Scholarship Application
LIANZA
PO Box 12 212
Wellington 6144
The LIANZA physical address:
Level 4, Stephenson & Turner House
156-158 Victoria Street
Wellington
Or email signed PDF to: awards@lianza.org.nz (subject to read “Edith Jessie Carnell
Travelling Scholarship”)
Entries for the Edith Jessie Carnell Travelling Scholarship close: 30 MAY 2016
Please attach:
1. A written statement summarising the professional aim for your travel and outline your
course of study, research, and/or conference attendance.
2. A plan and time-frame outlining how you will disseminate the results of your research or
study
3. The names and contact details of two referees
Rev11/12
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