2011 Centennial Application Form INDIVIDUAL FINAL 30 Mar 2011 v. 8.1 CENTENNIAL SCHOLARSHIP SCHEME APPLICATION FORM - INDIVIDUAL AWARDS Please use this form if you are applying to the Royal Aeronautical Society for an individual award from the Centennial Scholarship Fund. For guidance in completing the application form, please refer to the separate ‘Application Form Guidance Notes’ for Centennial Scholarship applications. If you wish to apply for an EADS Technology Masters Awards, please use the separate form and consult the additional guidelines. PLEASE TYPE YOUR APPLICATION OR USE BLACK INK. SECTION 1 – PERSONAL DETAILS 1. Full Name 2. Date of Birth 3. Address and Postcode 4. Nationality 5. Telephone/Mobile number(s) 6. Fax number (if applicable) 7. E-mail 8. RAeS Membership Grade 9. RAeS Membership Number 10. Organisation/University/School Please remember to let us know if your contact details change! SECTION 2 – APPLICATION DETAILS 11. Course or project title for which your application applies: .......................................................................................................................................... Organisation/University: ................................................................................................... If different from your current course/university/organisation, please state current details here: ………………………………………………………………………………………………………… 12. Previous submissions. State previous applications made to the Centennial Fund or other RAeS programmes such as the Aerospace Speakers’ Travel Grants and EADS Tech Masters Programme (including unsuccessful applications) and, where applicable, reference numbers. Please include dates and for successful applications the amount received. . Page 1 of 4 2011 Centennial Application Form INDIVIDUAL FINAL 30 Mar 2011 v. 8.1 13. Other awards/sponsorships. Please state details of awards/sponsorships you have received from other, non-RAeS sources and other awards/sponsorships you are applying for in connection with the project/course described in question 11. SECTION 3 – COMMITMENT AND ACHIEVEMENTS IN AEROSPACE/AVIATION 14. Please give an account of your education, qualifications and achievements with a career summary to date in pursuit of aeronautical ambitions and your future plans. (500 words maximum). Page 2 of 4 2011 Centennial Application Form INDIVIDUAL FINAL 30 Mar 2011 v. 8.1 SECTION 4 – FINANCIAL 15. Statement of case justifying an award and your reasons for seeking financial support from the Centennial Scholarship Fund. (300 words maximum) SECTION 5 – REFERENCES: Compulsory for all applications. Please refer to the Guidelines for information about your references which should be sent separately to the RAeS by the referee. 16. REFEREE #1 Address Name Email: Referee #1 – Reference letter to be sent directly to RAeS by referee. Letter posted to RAeS? YES/NO (please circle) RAeS Fellow/Member? YES/NO (please circle) 17. REFEREE #2 Name Address Email: Referee #2 – Reference letter to be sent directly to RAeS by referee. Letter posted to RAeS? YES/NO (please circle) RAeS Fellow/Member? YES/NO (please circle) Page 3 of 4 2011 Centennial Application Form INDIVIDUAL FINAL 30 Mar 2011 v. 8.1 SECTION 6 – FINANCIAL BREAKDOWN OF PROJECT 18. Summary of costs that would be met by an award. Please note that funds can support only a proportion of costs incurred by the project/course of study. You must also demonstrate other sources of funding e.g. sponsor/partner contributions, private income, income from other sources etc. Please state your costs in pounds sterling (£). Centennial Fund awards of over £5000 are given only in exceptional cases. The average award given in the past is between £1000 and £3000. Total amount of money applied for in this application: £……………… Payable to: ………………………………………………….. Breakdown of costs: Date money required: Other sources of funding: SECTION 7 – DECLARATION Signature and acceptance by applicant of Conditions of Awards I accept that the information given in this form is, to the best of my knowledge, accurate at the time of making the application. If I am awarded funding from elsewhere, I will notify the RAeS. In making this application, I agree to the Terms and Conditions of the RAeS Centennial Scholarship Fund. Signature ____________________ Date ____ / ____ / ________ SENDING YOUR APPLICATION CHECKLIST Individual Applications – Centennial fund Copy of offer letter from University Reference letter #1 – posted directly to RAeS by referee? Please send your completed application form, and supporting documentation to: Mr Tim Caines Board & Executive Team Secretary Royal Aeronautical Society No.4 Hamilton Place London W1J 7BQ, UK Tel + 44 (0)20 7670 4312 Reference letter #2 – posted directly to RAeS by referee? Mark the envelope, ‘Centennial Scholarship Awards’. Only signed, original copies received by the deadline date can be accepted. Page 4 of 4