THE UNIVERSITY OF QUEENSLAND
2016 TEACHING FELLOWSHIP SCHEME
APPLICATION FORM
PART A: NOMINATION COVER PAGE
Nominee contact details
Title
First and last name
Position title
School / Faculty
Email address
Telephone
Mobile
Fellowship focus
Fellowship title
20 words max
Discipline focus of Fellowship,
if relevant
Use keywords
Educational issue(s) to be
addressed in Fellowship
Use keywords
Abstract
In 150 words or less, describe the intended aim and key
activities of the proposed project
Preferred semester
Indicate your preference for Semester 1 or Semester 2,
2016 to undertake the Fellowship
Institute for Teaching and Learning Innovation (ITaLI)
www.itali.uq.edu.au
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Nominee’s Declaration
I agree to be nominated for a UQ Teaching Fellowship and agree to the conditions of the
Fellowship.
Signature
Date
Faculty Associate Dean (Academic) Certification
I support this nomination on the basis of the attached documentation. I undertake to support
this nominee in the activities associated with the UQ Teaching Fellowship in accordance with
the attached statement of support. I confirm that the information above is true and correct
and that the nominee named on this form is currently a staff member of this institution.
Associate
Dean
(Academic)
Faculty
Signature
Date
Head of School Certification
I certify that:
i) The program of activities, if funded under this application, can be accommodated within
the general facilities in my organisational unit and that sufficient working and office space
is available for any proposed additional staff.
ii) I am prepared to have the program of activities, if funded under this application, carried
out in my organisational unit under the circumstances set out by the Applicant as well as
support their residency component within ITaLI.
iii) I have noted the amount of time that the Applicant will be devoting to the project and
associated capacity-building activities and agree that it is appropriate to their workload. I
agree that teaching relief will be arranged if the funding application is successful.
Head of
School
School
Signature
Date
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PART B: FACULTY/SCHOOL STATEMENT OF SUPPORT
The statement of support should endorse the nomination, with specific reference to the
selection criteria. In addition, the statement may detail the direct and indirect support that
the Faculty or School will provide during the Fellowship. This statement should be
provided by the Faculty Associate Dean (Academic) or delegate in consultation with the
relevant Head/s of School/s.
(Maximum one page)
Institute for Teaching and Learning Innovation (ITaLI)
www.itali.uq.edu.au
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PART C: DESCRIPTION OF PROPOSED FELLOWSHIP ACTIVITIES, OUTCOMES,
TIMELINE AND BUDGET
The description must include:
- a discussion of the teaching and learning issue to be addressed and its alignment
with the challenges outlined in the UQ Student Strategy Green Paper
- a plan of activities/approach to address this issue
- the strategy for collaboration and dissemination within the University
- the potential impact on student learning
- a Fellowship timeline that identifies concurrent academic activities
- a project budget
(Maximum four pages)
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PART D: APPLICANT’S CAPACITY TO CONDUCT THE PROJECT
The applicant can demonstrate their capacity to undertake the project with evidence of, for
example:
- experience in managing projects
- capacity to innovate in university teaching
- leadership in teaching and learning within their discipline, School or Faculty
- publishing in the scholarship of teaching and learning
(Maximum one page)
Faculty Associate Deans (Academic) are welcome to provide nominations to ITaLI
(y.oberhollenzer@uq.edu.au) by 5pm on Friday, 11 December 2015.
Institute for Teaching and Learning Innovation (ITaLI)
www.itali.uq.edu.au
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