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APPLICATION FORM
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ADMISSION TO RESEARCH HIGHER DEGREE
POSTGRADUATE RESEARCH SCHOLARSHIP
NOTES FOR APPLICANTS
To apply for both admission to a research higher degree at Flinders University and a postgraduate research scholarship,
complete all pages of this form. Make sure you complete all relevant sections of the form. For further information refer to the
Application Guidelines and Information, Admission to Research Higher Degree, Postgraduate Research Scholarship document
Send your completed application and supporting documentation to the contact person listed on the individual scholarship
COURSE DETAILS
Indicate the course for which you wish to be considered for admission or in which you are currently enrolled.
Ph.D. in Archaeology
Are you currently
enrolled in this course?
Other degree (please specify) :
No
I wish to undertake/am
enrolled in this course:
AND wish to be/am enrolled
on the following basis:
Yes
If Yes, year of commencement:
Full-time
Internal
School/Department/Unit in which research will be/is being undertaken ARCHAEOLOGY / HUMANITIES
PERSONAL DETAILS
Name:
Title (Mr, Ms etc)
Family name
First Given Name
Previous Name:
Second Given Name
Student ID number:
Any previous family name (if applicable)
(if currently/previously a Flinders
student)
Date of Birth:
Gender:
Day
Month
Male
Female
Year
Address details:
Street address or GPO Box
Suburb or town
Contact telephone number
State or country
Mobile phone number
Postcode
Fax number
Email address:
Citizenship Status:
Australian citizen
Permanent Residents only
Date residency granted:
New Zealand citizen
Permanent Resident of Australia
(but not an Australian citizen)
Holder of a student visa, temporary
resident visa or visitor visa
Aboriginal or Torres Strait Islander status:
Yes
No
Will you be residing in Australia during
the study period?
Yes
No
International applicants only
Other
Country of birth
(if not Australia)
Did you meet residency requirements
for citizenship more than one year ago?
Indicate type of Visa:
Year of entry
(to Australia)
Country of Citizenship
Main language
spoken at home
Aboriginal
Both Aboriginal and TSI
Torres Strait Islander
Disabilities:
None of the above
Do you have a disability or medical condition which may affect your
studies? If “Yes”, please indicate below any disability that applies.
Hearing
Learning
No
Medical
Vision
Yes
No
Would you like information on support services?
Yes
Mobility
Other
ACADEMIC DETAILS
Degrees and Awards: Original or certified copies of academic transcripts, showing all subjects attempted and grades
received, except for studies undertaken at Flinders University, MUST be attached to this application.
Are you currently enrolled/previously been enrolled in a research higher degree?
No
Yes
(provide details below)
List in chronological order all university or other post-secondary courses attempted or completed.
Name of Degree/Award
Institution
Major Field of Study
Attempted but not
completed. Enter
year last enrolled
Completed or about
to complete. Enter
year last enrolled
Research Experience: A brief summary of your research experience must be attached. Include details of any publications,
research grants, patents, creative works or employment experience relevant to your proposed research project.
Academic referees: Provide the names and contact details of two academic referees. The faculty may contact the
nominated referees in relation to your application for admission. Nominated academic referees should have an informed,
personal and professional knowledge of your academic ability and should be able to exercise judgement of your research
potential. It is recommended that you select the supervisor of the most recent tertiary program in which you are/were enrolled
or the Head of Department or the Postgraduate Coordinator of the Department.
First Referee
Second Referee
Name:
Name:
Position:
Position:
Address:
Address:
Email:
Email:
APPLICATION FOR ADMISSION TO A RESEARCH HIGHER DEGREE
You will only be accepted for admission to candidature if the University is able to provide research facilities and supervision
appropriate to the proposed field of research.
The information about research expertise at Flinders University at http://www.flinders.edu.au/research/our-research/researchexpertise.cfm may provide assistance in identifying a potential supervisor.
Broad field of study in which you are interested
Proposed supervisor of research:
Expected date of commencement:
Indicate the number of hours per week available to pursue studies:
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Research proposal
Attach a research proposal, approximately 3-4 pages (A4) in length, which details the problem, hypothesis or question that you
will examine, the methodology or approach that you will use and the anticipated resources required for the research projec t to
be viable. You are strongly advised to prepare your research proposal in consultation with a potential supervisor.
OFFICE USE ONLY: Application for Admission
________________________________________________________________________________
Decision:
Authorised:
__ / __ / __
__________________________________________
Entered:
__ / __ / __
__________________________________________
________________________________________________________________________________
Comments:
__ / __ / __
Student Advised:
__________________________________________
APPLICATION FOR POSTGRADUATE RESEARCH SCHOLARSHIP
Have you already commenced the degree for which you are seeking the scholarship?
No
Yes
If “Yes”, Name of Supervisor:
If “No”, you must complete the Application for Admission to a Research Higher Degree found on of this form.
Are you currently, or have you previously been, in receipt of a scholarship or other postgraduate award?
No
Yes
If “Yes”, attach a statement detailing the nature of the award. Include the name of the award, its value, the
year it was granted, how long you held the award, the institution where you held the award, and the study funded
by the award.
Do you have any publications?
No
Yes
If “Yes”, complete a Publication Details form for each publication or other work that you wish to submit in
support of your application. Provide a copy or offprint of the publication if fewer than 5 pages in length, or a
photocopy of the first 5 pages of the publication showing all bibliographic information. See the Publications section
of the Guidelines for Ranking Applications for further information.
REFEREES REPORTS
Do you hold, or are you completing an Honours degree from Flinders University?
No
Yes
If “Yes”, you are not required to provide referee’s reports, unless instructed to do so under the Additional
Information section below.
Do you hold or are you completing an Honours degree from another Australian university?
No
Yes
If “Yes”, provide one referee’s report, unless instructed to provide two reports under the Additional Information
section below.
Do you hold a qualification other than an Honours degree?
No
Yes
If “Yes”, please complete the Additional Information section below.
ADDITIONAL INFORMATION FOR STUDENTS WISHING TO BE CONSIDERED AS A SPECIAL CASE:
(For further information refer to the section on Special Cases in the Guidelines for Ranking Applications.)
Do you hold a Masters degree by research?
No
Yes
If “Yes”, provide two referee’s reports. Attach copies of examiner's reports for your Masters degree if these are
available. A Masters degree by research is normally considered equivalent to Honours 1, Band B. Applicants
holding a Masters degree by research may request that their degree be considered equivalent to Honours 1 Band
A. Such requests must be supported with written evidence.
Do you hold a coursework Masters degree with a graded research component?
No
Yes
If “Yes”, provide two referee's reports. Attach a statement giving details of the duration of the degree,
weighting of the research component, the mark and grade for the research component, and a statement of
grading. Attach copies of examiner's reports for the research component of your coursework Masters degree if
these are available.
Do you hold a coursework Masters degree with a non-graded research component?
No
Yes
If “Yes”, provide two referee's reports. Attach a statement that details the duration of the degree and weighting
of the research component. Attach copies of examiner's reports for the research component of your coursework
Masters degree if these are available.
Do you hold an Honours degree at 2A level, which was awarded more than five years ago?
No
Yes
If “Yes”, provide two referee's reports. If applicable, attach a statement that details how your research potential
has changed since your degree was awarded.
Do you have any other academic qualifications and/or research experience?
No
Yes
If “Yes”, provide two referee's reports. Attach a statement giving details of the qualifications and/or research
experience.
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If you are required to provide referee’s report(s) forward the Academic Referee’s Confidential Report form to the referee(s) nominated on
page 2 of this application. Please follow the instructions contained in the form.
DECLARATION
I certify that to the best of my knowledge all documentation and information submitted or made available by me to the
University, whether in relation to any course of study or otherwise, is true, accurate and complete. I acknowledge that the
provision of inaccurate or incomplete information by myself, or a certifying authority, may result in the withdrawal of any offer of
enrolment, the cancellation of any enrolment allowed on the basis of acceptance of that offer and/or the cancellation of a
scholarship at any time prior to or during my enrolment. I consent to the collection, storage and disclosure of information
relating to record falsification or other irregular acts in accordance with Universities Australia procedures. I authorise Flinders
University to obtain from other educational institutions details of my enrolment and academic record at those institutions. I
authorise Flinders University to release information on my application for a scholarship to organisations offering scholarshi ps
for which I may be eligible.
Signature of Applicant
Date
Giving false or misleading information is a serious offence under the Criminal Code (Commonwealth).
APPLICATION FORM CHECKLIST
HAVE YOU PROVIDED:
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Yes
No
Not
Required
Yes
No
Not
Required
Yes
No
Not
Required
certified copies of academic transcripts for all studies attempted, except study at Flinders
University.
A brief summary of your research experience including details of any publications, research
grants, patents, creative works or employment experience relevant to your proposed research
project.
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A complete copy of the application and all supporting documents including your CV.
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A research proposal approximately 3-4 pages in length.
FOR POSTGRADUATE RESEARCH SCHOLARSHIP
Have you provided:
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Details of currently or previously held scholarships or postgraduate awards.
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An Applicant Publication Details form for each publication or other work that you wish to submit
in support of your application.
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A copy or offprint of each publication if fewer than 5 pages in length, or a copy of the first 5
pages of the publication showing all bibliographic information.
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Copies of examiners’ reports for your Masters degree by research.
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Copies of examiners’ reports for the research component of your coursework Masters degree.
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Other details of your coursework Masters degree.
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Details of how your research potential has changed since your Honours degree was awarded.
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Details of other academic qualifications or research experience.
Have you also:
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Forwarded Academic Referee's Confidential Report form(s) to the nominated referee(s).
Send your application (including the checklist) with supporting documentation to: the contact person
listed on the individual scholarship webpage at www.flinders.edu.au/scholarships
General RHD scholarship app 09/10/2015
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