Intercampus Collaborative Research Fund
Faculty of Medicine
Application Form for Staff wishing to access the Intercampus Collaborative
Research Fund
This fund is to assist with collaborative research between or with departments in the
Faculty of Medicine, ie Otago School of Medical Sciences, Dunedin School of
Medicine and Wellington and Christchurch Schools of Medicine and Health Sciences.
Funding is provided to meet travel and accommodation costs. Preference is given to
staff attempting to establish new, collaborative research projects.
Name of Applicant:
Department:
Who will attend the meeting? (Please list the staff and their department(s)and indicate who will be travelling)
Where is the meeting? (Please state the Department and School)
Purpose of Meeting (Please briefly advise the purpose of the meeting)
When is the Meeting?
(If a specific date has not been set please approximate)
Research project (Is this a new project?
Amount Requested
Has other funding been sought? Will there be an ongoing need for travel?)
(State approximate amount for Airfare, Accommodation, Transfers and Total)
Associate Dean Research
Date
The Associate Dean will forward this application to the Faculty Manager, who will
notify the applicant of the outcome
Manager, Faculty of Medicine
Mr Bruce Smith, Faculty of Medicine
Version 11/11/09
Date