Academic Fellowship Application Form Please complete this form and return a signed hardcopy via internal mail to The Academic Manager, the Reinvention Centre, Dept of Sociology An additional electronic copy should also be sent to reinvention@warwick.ac.uk Name of applicant Department / Centre Email address Telephone Title of Fellowship project Names of others involved (if applicable) Name Department/Centre Name Department/Centre Outline of proposed project Please include: Aims and objectives Teaching and learning aspects with reference to relevant academic literature Research questions/methods Project design and methods (including student involvement) Nature of collaboration with other departments/academic staff 1 Intended outcomes of the proposed project Which of the Reinvention Centre’s Working Principles does the project address? (Please include all that apply and give details of how they will be addressed) 1. Consolidating the ties between teaching and research 2. Encouraging undergraduate research within the curriculum 3. Redesigning the spaces within which students learn 4. Disseminating knowledge about researchbased learning across the HE sector Timescale Estimated Start date: Milestones and Targets throughout the duration of the project: Estimated Completion date: This project would be suitable for students from which discipline(s) and year(s) of study? Discipline(s): Year(s) of study: At which module(s) will the project be aimed? 2 How will the outcomes of the project be generalised to the department/faculty? How will the outcomes be disseminated more widely outside of the university? How will this project link with ongoing work in the Reinvention Centre? How will you evaluate the project? Budget Please state the total amount of funding for which you are applying (up to a maximum of £10,000): Please give a detailed breakdown of the costs associated with the project Statement of ethics By signing below, you are confirming that your project conforms to the University’s Guidelines on Ethical Practice, which are available to view at 3 http://www2.warwick.ac.uk/services/rss/services/ethics/statement/guidance/# Signature of applicant Signature: Name (please print): Date: Declaration of support by Chair of Department/Director of Centre Signature: Name (please print): Date: 4