Locked Bag 1797
Penrith NSW 2751 Australia
HAWKESBURY INSTITUTE FOR THE ENVIRONMENT
SUMMER RESEARCH SCHOLARSHIPS
APPLICATION FORM – 2015/2016
Name:
Student ID:
Postal address:
Telephone:
Facsimile:
Email:
Name of proposed supervisor:
Proposed title:
Brief outline of proposed project (100 words max):
What resources will be required to complete the project?
Student Signature: __________________________________ Date: ____________
The Institute will access a copy of your undergraduate academic transcript. If you are
not previously a UWS student, please attach a transcript showing your Grade Point
Average or equivalent.
This section is to be completed by your proposed supervisor:
Are you willing to supervise this project?
□
Yes
□
No
Are the resources available to complete this project?
□
Yes
□
No
Signature: __________________________________ Date: ____________
Once signatures are obtained, please forward this application and accompanying
documentation to be received no later than Friday 4 December 2015
Dr David Harland
Room G.67, Building R2, Hawkesbury Campus
Locked Bag 1797, Penrith, NSW, 2751
02 4570 1125 or d.harland@uws.edu.au
I approve this scholarship payment for 2015/2016
Name: ________________________________ Position: ______________________
Signature: _________________________________________ Date: ____________