Philosophy Program School of Humanities Private Bag 41 Hobart Tasmania 7001 Australia Ph: + 61 3 6226 7581 Fax: + 61 3 6226 7847 CRICOS Provider Code 00586B Humanities.Admin@utas.edu.au Applications Form Tasmanian Buddhist Studies in India Exchange Program - HPA2/376 APPLICATIONS CLOSE: End of August Information for the exchange program can be found at: http://www.utas.edu.au/humanities/home/gender-studies/buddhist-studies-in-india-exchange-program APPLICANT DETAILS Family Name: Click here to enter text. Given Name(s): Click here to enter text. Address: Student ID No: Click here to enter text. (If current UTas student) DOB: Click here to enter a date. Home Phone: Click here to enter text. Click here to enter text. Mobile: Click here to enter text. Email address: Current Course of Study: Enter text. Click here to enter text. Institution (if not Utas): Enter text. BRIEFLY COMMENT ON THE FOLLOWING (if insufficient space, please attach a separate word document) Your academic plans: Click here to enter text. How does the TBSIEP fit into your academic plans?: Click here to enter text. Overseas or multicultural experience (if any): Click here to enter text. ACADEMIC REFEREE Name: Position: Click here to enter text. Click here to enter text. Day time telephone: Email Address: Click here to enter text. Click here to enter text. PROGRAM INFORMATION Up to fifteen students from the University of Tasmania, and other cooperating institutions, spend one month at the Central University of Tibetan Studies. The curriculum studied comprises an intensive introduction to Buddhist philosophy, Tibetan Buddhist Hermeneutics and Tibetan History and Culture; Eligible applicants must have completed their first year of University study (or expect to complete by commencement of program); Exchange Program dates: End of December to end of January; The Philosophy Program organises all travel, accommodation, full board and limited sightseeing; Students travelling on University business, including TBSIEP students, have an obligation to follow the University of Tasmania’s Travel Guidelines and are eligible for cover by the University of Tasmania’s Student Travel Insurance policy for the duration of the program. Student financial contribution to the Exchange Program: Note: students should not rely on receipt of a scholarship alone to fund their program participation. Approximately $4500 (to be confirmed). This covers airfares from home state to India and return, all accommodation, full board and limited sightseeing; This is a HECS assessable unit. Appropriate HECS fees for the 25% unit HPA276/376 as displayed on the Course and Unit handbook; Upon selection, a non-refundable deposit of $500 is required to confirm and secure your place; Further pre-travel advice including passport, visa, medical, insurance and cultural advice will be provided. SCHOLARSHIP INFORMATION Students in receipt of any other UTAS grant or scholarship will not be eligible to receive a Utas provided scholarship (with the exception of OS-HELP loans and Equity Scholarships). Tasmanian Overseas Scholarship (up to $3000) – subject to eligibility; OS-HELP loan (up to $5000). I confirm I have read and understood the above Program Information; I have attached a certified copy of my academic transcript from my home institution; or I am a current or past UTas student: ID No _________________ ____________________________________ _____ Signature / Printed Name Office Use Only _______________________ Date Date Received: ___ /___ /___ Selection committee comments: Application Supported: YES NO Scholarship Supported: YES NO 2 of 2