University of Nottingham EPSRC Doctoral Prizes 2016 APPLICATION FORM APPLICANT DETAILS Surname/Family name: Other Names: Email address: Daytime telephone: Mobile telephone: Student Fees Status: Home: EU: Overseas: *Overseas applicants must contact the UK Border agency to ensure visa eligibility PhD DETAILS Title of PhD: PhD submission date/expected submission date: *must be before Prize start date PhD award date: (Please indicate if actual or expected) Awarding University: Awarding School/ Department/Division: Grant reference for the EPSRC funding you received during your Doctoral award: (Doctoral Training Grant/project grant/other, please specify) DOCTORAL PRIZE PROJECT DETAILS School/Department/Division where the EPSRC Doctoral Prize will be held: Proposed duration of project (months, 24 months maximum): Title of proposed project: Please make your case for support below, under the headings in each section Maximum of 500 words for the five sections. Your main objectives and proposed activities for the year: EPSRC Doctoral Prizes 6/04/2016 1 Interdisciplinary applications are encouraged. If your project is an interdisciplinary one please give details: Key publications that could result from your work: The potential impact of activities including beneficiaries of your PhD research and benefits to them: Details of knowledge transfer and outreach activities for example engagement of users: Maximum of 500 words Word Count: Ethical information. Please identify and address here any ethical issues related to your work: PERSONAL STATEMENT Please give details of your aspirations in the long term, outline how you believe your career will benefit from the award of an EPSRC Doctoral Prize and how the support outlined in the further particulars will be advantageous to you: Maximum of 500 words Word Count: EPSRC Doctoral Prizes 6/04/2016 2 REFEREES Please complete the contact details for two referees, one of whom should be your principal supervisor. First Referee Name: Telephone number: Email address: Institution/Organisation: Position: Second Referee Name: Telephone number: Email address: Institution/Organisation: Position: PROJECT SPONSOR The EPSRC requires each successful Doctoral Prize holder be assigned a Project Sponsor who will act as mentor and provide on-going guidance and support the transition to an independent researcher. The Project Sponsor is not their PhD supervisor. Prior to submitting your application you must discuss your research proposal with an academic member of staff within the School. Name: Telephone number: Email address: School/Research Division: Position: HEAD OF SCHOOL/RESEARCH DIVISION The Head of School/Research Division where the candidate’s Doctoral Prize tenure will take place must provide a statement of support detailing how the project will fit with the School’s strategy. Name: Telephone number: Email address: School/Research Division: Position: Please ensure that you email your named referees and your project sponsor a copy of the reference form or sponsor’s form together with a copy of your completed application form and a copy of the further particulars for the scheme to enable them to write the reference and the project sponsor’s statement of support. EPSRC Doctoral Prizes 6/04/2016 3 Annex 1 A support grant is available. Please give details of proposed resources and costs needed to increase the impact of the PhD. (You should detail costs for consumables including materials and equipment, conference and workshop costs, including accommodation and travel plus any costs associated with outreach activity). Costs should comply with the university’s procurement and staff travel policies. EPSRC Doctoral Prizes 6/04/2016 4 Email your completed application to pg-funding@nottingham.ac.uk by 15 July 2016 (noon) Your application must include the following: 1. A completed University of Nottingham EPSRC Doctoral Prize application form 2. Annex 1 detailing the proposed costs of your project 3. A detailed CV including full academic history, research and publications to date 4. Two references, one of which is from the principal PhD supervisor 5. A completed EPSRC Doctoral Prize Project Sponsor statement of support 6. A signed supporting statement from the relevant Head of School/Research Division indicating how the research proposal would fit with the School’s strategy 7. Equal opportunities form Please name the files in the following format: Candidate surname-initial-application.doc (including Annexe 1) (or .pdf) Candidate surname-initial-CV.doc (or .pdf) Candidate surname-initial-Refsurname.doc (or .pdf) Candidate surname-initial-Sponsor.doc (or .pdf) Candidate surname-initial-Hos support.doc (or .pdf) Candidate surname-initial-EqualOpps.doc (or .pdf) The application form and supporting documents must be signed, scanned and emailed to pgfunding@nottingham.ac.uk by 15 July 2016 (noon). Alternatively, supporting documents completed by a 3rd party may be emailed directly from their own ‘ac.uk’ email account to pg-funding@nottingham.ac.uk by 15 July 2016 (noon). EPSRC Doctoral Prizes 6/04/2016 5