Surname Name Office use only RF/RS RA BRITISH SCHOOL AT ROME Rome Fellowships, Scholarships and Awards in Ancient, Medieval and Later Italian Studies 2016–17 Please read the accompanying information sheet before completing this form. Your application must respect the page-end indicators given in the form; and use a minimum font size of 11pt. two reference forms are attached. Complete Section 1 and send one form to each referee, with a copy of your application. Ask your referees to return the completed reference form by Thursday 14 January 2016. You must submit your application as an e-mail attachment (as a Word document or pdf) to the BSR Registrar, bsr@britac.ac.uk, to arrive no later than Thursday 14 January 2016. Please give in the subject line: BSR Award [your surname] [your name]. 1. Name & Surname 3. Tel. 4. E-mail 5. Nationality 6. Present position 7. Summary of academic career (include university, subject, degree title and class, date started, date obtained) 8. (a) Date doctorate submitted (month and year) (if applicable) 2. Address (b) If applying for a Rome Fellowship and the answer in 8(a) is before January 2014, set out your case for being considered. Note that progression through other research fellowships or assistantships and teaching posts will not be considered a valid reason. However, someone whose career has been interrupted by, for example, maternity leave, family commitments or illness, will be considered sympathetically 9. Title of doctorate 10. Publications — summarise in the space available 11. (a) Title of project for which support is sought (b) Date started 12. (d) Support received to date Award applied for (please ‘tick’ appropriate box) Rome Fellowship/Scholarship only (c) Anticipated completion date Rome Award only Rome Fellowship/Scholarship — or Rome Award if Fellowship/Scholarship application is unsuccessful End of page 1 Name 13. Surname (a) Have you made any other applications in connection with this project? If so, with what results? (Please keep the BSR informed of the outcome of such applications.) (b) Applicants in receipt of an AHRC or equivalent award may receive the title of Award-holder or Scholar/Fellow, and will be allocated a room at the BSR, for which they will be charged at the appropriate rate. The BSR will consider financial support only if AHRC or equivalent award-holders are able to demonstrate that they have exhausted other funding options before applying to receive the full benefit of the BSR award. Please give details of your funding situation in the light of this statement (c) Applicants who are not UK or Commonwealth citizens and who are eligible for support from their own national bodies should apply to these in the first place. Reasons for not doing so should be given here 14. Details of previous awards received from the BSR: include details of the date and type of award, the project for which the award was made, and the date and place of (planned) publication 15. Knowledge of Italian, written and spoken, or plans for acquiring such knowledge 16. FOR ROME AWARD CANDIDATES (including those submitting an application for a Fellowship/Scholarship or Award) (a) Duration of Award requested (normally 3 months) (b) 17. Months (between October 2016 and March 2017) when you could take up an award. Please note that Rome Awards will normally be offered for October–December 2016 OR January–March 2017 Names, full postal addresses, telephone numbers and e-mail addresses of two referees who are familiar with your research project and have agreed to write in support of your application. Where appropriate, one referee should be your supervisor. For post-doctoral applicants, it is expected that one of the referees will be from outside your home institution 1. 2. Name Address Tel. E-mail 18. Please complete Section 18 on pages 3–4 ACCESS Applicants with special needs are requested to contact the Registrar before submitting their application to discuss their requirements. The British School at Rome is a charity registered in England and Wales (no. 314176). It is registered under the Data Protection Act 1998 [Registration Number: K0335060] and adheres to the Data Protection Principles. Applicants should be aware that information they provide will be stored in electronic form. It will be provided to those who assess applications and to staff of the BSR, and will be used to compile published lists of award-holders. End of page 2 Name 18. (a) (b) Surname Proposed research to be undertaken Your responses to question 18 should take up a total of no more than two sides of A4, minimum font size 11pt. You may adjust the size of the boxes to fit your responses Outline of proposed research to be undertaken. This should be written so as to be understandable to a general academic audience and should indicate how the project might contribute to one or more of the BSR’s current research themes i. Why do you need to spend time in Rome to undertake the work? Include here details of the key archives, galleries, libraries, museums and/or sites that you need to visit, and explain why these are relevant to your project. ii. Have you checked already that the archive resources that you wish to use are accessible? You are welcome to consult the BSR in advance of submitting your application for advice (library@bsrome.it). No Yes (c) Short bibliography of major works relevant to your topic (d) For applicants who, if unsuccessful in an application for a Rome Fellowship/Scholarship, wish to be considered for a Rome Award Give details of which elements of the research outlined in 18(a) you would undertake if offered only a three-month Award I confirm that the information given in this application is, to the best of my knowledge, complete and accurate. Sending this form to the BSR constitutes your confirmation of this and your acceptance of all the terms, conditions and notices contained in the notes for applicants. Signature Date End of page 4 British School at Rome Monitoring Form As part of the British School at Rome’s commitment to equal opportunities, the age, gender and ethnic origin of people who apply is monitored. We should be grateful, therefore, if you would complete this form. Any information that you give will remain confidential. The form will be detached from your application, will not form any part of the selection process, and will be used only for the purposes of monitoring. Please do not sign the form, or give your name. If sending your application as a pdf, please send this page separately. Thank you for your cooperation. Date of birth (dd/mm/yyyy) Female / Male / Prefer not to say Please show which group best describes your ethnic origin or descent by ticking ONE of the boxes below. The groups are derived from the 2001 census categories, as recommended by ACAS. Asian or Asian British Bangladeshi Any other Asian background, please write in box Indian Pakistani Caribbean Any other Black background, please write in box Black or Black British African Chinese Chinese Any other, please write in box Mixed heritage White and Asian White and Black African White and Black Caribbean Any other mixed background, please write in box White British English Irish Scottish Welsh Any other White background, please write in box Other ethnic group Any other ethnic group, please write in box Decline to specify Do you consider yourself to have a disability? No Yes FAHL 2016 Applicant’s Name Applicant’s Surname BRITISH SCHOOL AT ROME CONFIDENTIAL REFERENCE REFEREE The completed form should be returned by Thursday 14 January 2016. We would prefer to receive the reference by e-mail at bsr@britac.ac.uk; but you may also fax it to +44 (0)20 7969 5401 or send by post to The Registrar, The British School at Rome, 10 Carlton House Terrace, London SW1Y 5AH. Thank you for your help. 1. Applicant’s name 2. Referee’s name 3. REFERENCE Please use the space provided to comment on the scholarly importance of the project, on the practicality of the proposed research being undertaken in the time period specified, on the applicant’s ability to carry it out and on how the applicant would fit into the BSR’s community. Signature Award applied for Date The British School at Rome is registered under the Data Protection Act 1998 and complies with the provisions of the Act. The BSR is not exempt from disclosing the content of a reference to an applicant invoking the Data Protection Act, unless by doing so the identity of the author of the reference is revealed. The policy of the BSR is to maintain strict confidentiality, unless the referee explicitly consents to the disclosure of his or her identity. Please indicate below if you are willing for your reference to be disclosed. Otherwise, confidentiality will be preserved and, where necessary to protect your identity, the content of your reference will not be revealed to the applicant. I am willing for my reference to be disclosed to the applicant Yes No Applicant’s Name Applicant’s Surname BRITISH SCHOOL AT ROME CONFIDENTIAL REFERENCE REFEREE The completed form should be returned by Thursday 14 January 2016. We would prefer to receive the reference by e-mail at bsr@britac.ac.uk; but you may also fax it to +44 (0)20 7969 5401 or send by post to The Registrar, The British School at Rome, 10 Carlton House Terrace, London SW1Y 5AH. Thank you for your help. 1. Applicant’s name 2. Referee’s name 3. REFERENCE Please use the space provided to comment on the scholarly importance of the project, on the practicality of the proposed research being undertaken in the time period specified, on the applicant’s ability to carry it out and on how the applicant would fit into the BSR’s community. Signature Award applied for Date The British School at Rome is registered under the Data Protection Act 1998 and complies with the provisions of the Act. The BSR is not exempt from disclosing the content of a reference to an applicant invoking the Data Protection Act, unless by doing so the identity of the author of the reference is revealed. The policy of the BSR is to maintain strict confidentiality, unless the referee explicitly consents to the disclosure of his or her identity. Please indicate below if you are willing for your reference to be disclosed. Otherwise, confidentiality will be preserved and, where necessary to protect your identity, the content of your reference will not be revealed to the applicant. I am willing for my reference to be disclosed to the applicant Yes No