Blavatnik Postdoctoral Fellowships Programme for Israeli Scientists Section A: Please refer to the Guidelines for Applicants: Blavatnik Postdoctoral Research Fellowship Scheme. You must include a CV (maximum 3 pages) with your application. Copies of this application form should be submitted to: Blavatnik.fellowship@britishcouncil.org.il in MS Word and PDF formats (total file sizes should not exceed 2 Megabytes total) before 1 March 2016 at 1600 GMT A1. Details of applicant Name: ID Number: Current Department: Current Institution: Email: Tel: Mobile: Fax: List of relevant publications (up to a maximum of 6) Please attach a current CV (maximum 3 pages) * A2. Biography Please include a brief biography (maximum 250 words) A3. Details of host Name: Position: Department: Institute: The Blavatnik Postdoctoral Fellowships Programme is delivered by the British Council in Israel Page 1 of 4 Blavatnik Postdoctoral Fellowships Programme for Israeli Scientists Application Form A4. Current Status Please indicate with X PhD student. Please indicate year of study Post-Doc Other. Please give details A5. Synopsis of current work A6. Statement of career plans A7. Confirmation Please sign to confirm that if successfully awarded a fellowship all ethical standards, relevant legal requirements, local organisational policies and all regulatory ethical and governance requirements of the UK (as applicable)will be respected. Typing your name will be taken as being as binding as your signature Page 2 of 4 The Blavatnik Postdoctoral Fellowships Programme is delivered by the British Council in Israel Blavatnik Postdoctoral Fellowships Programme for Israeli Scientists Application Form Section B: B1. Length of fellowship requested Please indicate length of fellowship requested from one to two years. Fellows will receive an annual stipend of £30,000 and fellowships will be tenable for up to two years. Funding for the second year is subject to satisfactory undertaking of the Fellowship and subject to approval of the grant committee. B2. Proposed Activity – Title B3. Proposed Activity – Summary (maximum 300 words) Please give a summary of the activity to be undertaken in plain English. This should be a statement for a nonspecialist lay audience about the activity and its potential benefits. B4. Proposed Activity – Description (maximum 1500 words not including references) Please give a full description of the activity including the essence of the activity, its expected outcome and the intended value. B5. Risks This section should contain an assessment of the associated risks with achieving the aims of the proposed activity and respective mitigation B6. Future Cooperation Please indicate how the experience could help foster cooperation between the UK and Israel B7. Information Please indicate how you became aware of the Blavatnik Postdoctoral Research Fellowship Programme Page 3 of 4 The Blavatnik Postdoctoral Fellowships Programme is delivered by the British Council in Israel Blavatnik Postdoctoral Fellowships Programme for Israeli Scientists Application Form Section C: Host institution Agreement Please refer to the Guidelines for Applicants/ Host Labs: Blavatnik Postdoctoral Research Fellowship Scheme. Name of Applicant Applicant ID number Proposed Activity Title C1. Details of Host Institute (Head of Lab) Name: Department: Name of Institution: Email: Tel: Mobile: Fax: List of relevant publications (up to a maximum of 6) Please attach a current CV (maximum 3 pages) * C2. Support of application (maximum 500 words) C3. Future cooperation Please indicate how the experience of hosting a Blavatnik Fellow could help foster cooperation between the UK and Israel C3. Signature of individual and Stamp of Institution The Blavatnik Postdoctoral Research Fellowship provides the recipient with a subsistence allowance to cover the fellow's living costs. The fellow is not, therefore, an employee of the Blavatnik Postdoctoral Research Fellowship, nor the British Council who administers the scheme, which cannot accept liability for his/her actions, health, safety or research expenditures. The host institute in accepting the fellow accepts the responsibility of protecting both itself and the fellow as appropriate to the normal needs of a guest worker. The host institute also accepts to provide the necessary materials and facilities. Page 4 of 4 The Blavatnik Postdoctoral Fellowships Programme is delivered by the British Council in Israel