Tropical Agriculture Award Fund Application Form

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Tropical Agriculture Award Fund Application Form
International Study Awards (eight week awards for MSc students)
Personal Information
Surname
M/F
First Name
Middle name
Permanent Address
Address for correspondence
Telephone
Current Email
Permanent Email (if different)
Date of Birth
Nationality
Passport No
Health
Do you have any medical condition that could affect your ability to work in a remote area?
If so please attach a letter from your GP confirming that you are fit to undertake your proposed
assignment
Education
Most recent first (include current course) and only back to A levels
From
To
Name and location of
institution
Qualifications
gained
Title and content of Full/partcourse
time
Languages Please rate whether 1: fluent, 2:working knowledge or 3: basic
Language
1
2
3
Employment History
From
To
Organisation
Description of
(Name, address and type) post held
Responsibilities Reasons for leaving
Please account for any periods not covered elsewhere.
Interests
Please give details of spare time activities that are relevant to your application such as voluntary work.
Also demonstrate your interest in development issues and/or your research interests. Give positions of
responsibility held.
Activity
Position
Future Career
What field of work do you hope to follow in planning your future career?
2
Project to be undertaken for MSc dissertation
Please expand the boxes as necessary in order to give the information needed, however, the
project description and justification should not exceed two sides of A4
Name of project
Country
Host Institution
Period you plan to be there
Start date
End date
Detailed description of the project (aims and objectives; study area; methodology; expected results)
Please explain how this field assignment benefits and links into your MSc course
Description of the host/employing organization (and website if available): please confirm their
willingness to host you (attach copies of relevant correspondence) and indicate what support they will
offer
Wider relevance and impact of the project (with particular reference to the objectives of the TAAF)
3
Please provide a detailed budget breakdown and total expenses. Examples of eligible costs are given
in the table. Please insert additional rows as required.
Item
Return Airfare
Visa costs
Medical costs (e.g. vaccinations/malaria prophylaxis)
Subsistence costs
In-country travel expenses
Research equipment
Translator/field assistant costs
Other (please specify)
Cost
Total
Have you applied for or received any other award or grant towards funding of your participation in the
project? If yes, what is the total of other awards (do not include personal savings or loans)?
Please give a breakdown of other funding sources, and specify if the contribution covers a particular
budget item (e.g. airfare, or research equipment). Use the table below as a guide.
Other funding sources
Indicate how much has been secured and
what it covers or whether the application is
still pending
University/College grant (please specify)
Other charitable body (please specify)
Private sector grant (please specify)
Personal savings
Loan
Other (please specify)
References Applicants should request their Course Supervisor and Head of Department to send
emailed references to taa_award_fund@taa.org.uk and secretary_taaf@taa.org.uk before the closing
date for receipt of applications. For further guidance please refer to the Call for Applications for
International Study Awards.
Supervisor details (name, address, telephone, e-mail, position)
Supervisor comments
Head of Department (name, address, telephone, e-mail)
Head of Department endorsement
4
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