1
AUSTRALIAN FEDERATION of GRADUATE WOMEN Inc
APPLICATION FORM
2016 Two Barbara Hale Fellowships
Value: One of $10,000 and One of $9,000
2016 AFGW Fellowship: Value $8,000
There is a single application form for all of the Fellowships. The AFGW selection committee will determine the appropriate
award for each recipient.
Closing Date: Midnight Australian Eastern Standard Time (AEST) Friday, 31st May, 2016
Eligibility: Available to women who are Australian citizens or permanent residents of Australia and are enrolled for a PhD degree
by research in any Australian university. The funds are to be used for a specific project or purpose for PhD research in any field.
Tenure (length) of proposed project from 01 October 2016: minimum eight (8) months; maximum twelve (12) months
Guidelines: It is essential that you read the Guidelines before completing this form as they contain all necessary information. It
should not be necessary to request extra information. All communication will be included in the assessment process.
Indicate which Fellowships you wish to apply for. You may apply for both.
Barbara Hale Fellowship
Australian Federation of Graduate Women Fellowship
Send the completed Application Form with relevant attachments to:
Barbara Murray, AFGW Fellowships Officer afgw.fellowships@gmail.com
NAME:
Title
Dr
Mrs
Ms
Miss
Family Name
Preferred First
Name
Given Names
Date of Birth
Are you an Australian citizen?
Yes
No
If not, are you a permanent
Australian resident?
Yes
No
OTHER DETAILS:
Mailing Address
Mobile Number
Telephone (H) (include
area code)
E-mail Address
ACADEMIC QUALIFICATIONS (from most recent):
1
Year
Institution
Award
Surname conferred
under (if different from
that above)
2
3
2
CURRENT ENROLMENT:
Degree
Faculty/School
Institution
Degree (if different) for which the
Fellowship/s is sought)
Project for which the Fellowship/s is
sought)
Thesis/Project Title
Commencement Date
Expected Completion Date
Commencement Date (must be after 01
October 2016)
Expected Completion Date
Summary of your research (limit of 800
words)
Purpose for which the Fellowship Funds
would be used
Details of Budget (See Guidelines)
Other financial support already granted
or for which you have applied
Additional brief information that may
support your application: (Refer to
Guidelines)
Name and Contact Details of Academic
Referees (Refer to Guidelines)
Brief Summary for Publicity Purposes
(refer to the guidelines)
Conditions of the Award
1.
2.
If successful, I agree to acknowledge a) the Barbara Hale or the AFGW
Fellowship by name and b) AFGW’s financial support in any publication (including
any thesis) that results from the work undertaken
If successful, I will provide a report to AFGW on the conclusion of the project.
If I am forced to change my initial schedule because of unforeseen or
unavoidable circumstances, I agree to obtain prior written approval from the AFGW
Fellowship Officer.
Signature:
(electronic or typed is acceptable)
Date:
CHECKLIST: NB: Applications must arrive by midnight AEST 31st May 2016. Late applications will not be considered.
Ensure that you have attached and/or included the following essential documentation:completed application form
your contact details
recent photograph in digital format
evidence of Australian citizenship or permanent residency
copy of your academic record and award of degree(s)
evidence of enrolment or acceptance
names and contact details of 2 referees
any other supporting information you wish to add (please keep this to a minimum)
brief summary of the project which may be used for publicity purposes.
agreement to the Conditions of the Grant
signature and date on the application form (typed signature is acceptable).