NRF FELLOWSHIP REGISTRATION FORM Have you applied for the NRF Fellowship before? No Yes, _______________ (If yes, please specify the year of application?) INSTRUCTIONS: 1. To apply for the Singapore NRF Fellowship, applicants will first need to sign up for a free user account on the NRF’s Research, Innovation and Technology Administration (RITA) system at (https://rita.nrf.gov.sg/default.aspx), if they do not already have an existing RITA user account, in order to submit applications to NRF. 2. The following documents must be attached with this registration form in the RITA system: - One electronic copy of Detailed Curriculum Vitae (CV) - One electronic copy of Research Proposal 3. All information is treated in confidence. The information is furnished to the National Research Foundation with the understanding that it shall be used or disclosed for evaluation, reference and reporting purposes. 4. All information provided in this application must be true. False particulars or wilful suppression of material facts will render the applicant liable to disqualifications, or - if awarded - to withdrawal and/or appropriate legal proceedings. SECTION A: GENERAL 1 PERSONAL PARTICULARS * Delete as appropriate Reference Number (generated by RITA) NRF2014NRF-NRFF001-xxx Name (underline surname) Nationality Singapore Permanent Resident * Yes / No Date of Birth (dd/mm/yyyy) Gender Age (at time of application) * Male / Female Current Country of Location Address Contact No Email Address Research ID / ORCID No. (if any) Number of Citations h-Index ORCID provides a persistent digital identifier that distinguishes you from every other researcher and, through integration in key research workflows such as manuscript and grant submission, supports automated linkages between you and your professional activities ensuring that your work is recognized. Find out more at http://orcid.org/ 2 EMPLOYMENT DETAILS Current Organisation / Department Current Designation Number of years in current position 3 ACADEMIC QUALIFICATIONS PhD Degree (Discipline) Date Obtained Awarding University / Country 4 PROSPECTIVE HOST INSTITUTION Please list your top 3 choices of prospective host institutions and the relevant departments. Please note that the research grant to be provided under the Singapore NRF Fellowship Scheme can only be used to fund research conducted in Singapore. Choices Host Institution Department 1st 2nd 3rd 5 LIST OF PUBLICATIONS (TOP 3) Please list your 3 most significant publications, stating the impact factors for each. All information is treated in confidence. The information is furnished to the National Research Foundation with the understanding that it shall be used or disclosed for evaluation, reference and reporting purposes. NRF reserves the rights to reject applications with incomplete information or supporting documents. 6 DECLARATION OF OTHER FUNDING SUPPORT Grant Title and ID Funding Agency Amount (S$’000) Years of Support Expiry Date Role Played SECTION B: PROJECT DETAILS 7 RESEARCH PROPOSAL Title of Project (i) AREA OF RESEARCH Please select a discipline that best illustrate your proposal research area. Biological Sciences Engineering Natural Sciences Molecular Biology Bioengineering Earth Science Genetics Chemical Engineering Energy Biophysics Civil and Architecture Engineering Food Science Microbiology Electrical & Electronics Engineering Chemistry Ecology Environmental Engineering Physics Biology Material Science and Engineering Polymer Research Bioengineering Mechanical Engineering Water Research Biomedical Sciences Computer and Related Sciences Pharmacy Computer Programming Immunology Electronic Data Processing Cytology Information Sciences Neuroscience Software Development Pathology Systems Analysis Virology Computer Engineering Others (please specify) Pharmacology All information is treated in confidence. The information is furnished to the National Research Foundation with the understanding that it shall be used or disclosed for evaluation, reference and reporting purposes. NRF reserves the rights to reject applications with incomplete information or supporting documents. 8 RESEARCH PLAN AND CAREER OBJECTIVES (i) What do you plan to do in Singapore? (ii) Why do you want to conduct your research in Singapore? How would your research value add to the Singapore research landscape? (iii) What are your plans in building up a sustainable research group / capability in Singapore? All information is treated in confidence. The information is furnished to the National Research Foundation with the understanding that it shall be used or disclosed for evaluation, reference and reporting purposes. NRF reserves the rights to reject applications with incomplete information or supporting documents. SECTION C: ANY OTHER INFORMATION (i) REFEREES Applicants must provide the names and contact details of 5 referees, who must be willing to provide NRF with a recommendation if contacted. Nominated referees should be familiar with the applicant’s research work and be able to comment on the applicant’s track record as well as personal character. Relatives of the applicant may not serve as referees for this application. *Only referees of shortlisted applicants will be required to submit the recommendation letters. Referee 1 Name of Referee Email Current Organisation / Department Current Designation Relationship to applicant Number of Years known Referee 2 Name of Referee Email Current Organisation / Department Current Designation Relationship to applicant Number of Years known Referee 3 Name of Referee Email Current Organisation / Department Current Designation Relationship to applicant Number of Years known Referee 4 Name of Referee Email Current Organisation / Department Current Designation Relationship to applicant Number of Years known Referee 5 Name of Referee Email Current Organisation / Department Current Designation Relationship to applicant Number of Years known All information is treated in confidence. The information is furnished to the National Research Foundation with the understanding that it shall be used or disclosed for evaluation, reference and reporting purposes. NRF reserves the rights to reject applications with incomplete information or supporting documents. (ii) HOW DO YOU KNOW ABOUT THIS PROGRAMME? NRF Posters / Advertisement NRF Website Singapore Universities Overseas Universities Contact Singapore Existing NRF Fellows Word of mouth Others, please specify: All information is treated in confidence. The information is furnished to the National Research Foundation with the understanding that it shall be used or disclosed for evaluation, reference and reporting purposes. NRF reserves the rights to reject applications with incomplete information or supporting documents.