VISITING STIPENDIARY FELLOWSHIP SCHEME 2015-16 Application Form Last name: First name(s): Title: Current academic appointment: Address for correspondence: Telephone: Email: Period for which Fellowship is sought From (day, month & year): To (day, month & year): If your application is unsuccessful, do you wish to be considered for a non-stipendiary YES / Visiting Research Fellowship? NO Title of research to be pursued during the Fellowship (NB: a research proposal, maximum 2000 words, must be attached): Two academic references, specific to the Fellowship, must be submitted with the application. Please give the names, institutions and email addresses of the referees email: email: Please ensure that you are submitting all relevant documentation by using the checklist on the next page. ISA Visiting Stipendiary Fellowships Scheme 2013-14: Call for Applications Declaration and Checklist I have read and accept the terms on which the Fellowships are offered. Please find attached: An application form A short CV (not usually longer than four pages) The research proposal (maximum: 2000 words) The scholarly engagement proposal (approximately 1000 words) Two academic references specific to the Fellowship. Signed ..... …………………………………………………………………… Date ……………………………... An electronic signature is acceptable. Where did you see the advertisement? …………………………………………………………………… Institute of Latin American Studies, School of Advanced Study, University of London, Senate House, Malet Street, LONDON WC1E 7HU Fax (+44) (0)20 7862 8886 Email ilas@sas.ac.uk Further information is available at www.ilas.sas.ac.uk 2 ISA Visiting Stipendiary Fellowships Scheme 2013-14: Call for Applications