The Gerald Kerkut Charitable Trust
Application for a part-funded PhD Studentship
Forms are to be completed and submitted by supervisors. The closing date for applications for studentships
commencing in October 2017 is October 17th 2016. Applicants will be notified about the success of their
application before Christmas. Applications will not be accepted directly from students.
Please read the Terms and Conditions before completing the form
1.
Full address of the Department or School
2.
Proposed supervisor(s):
NAME
APPOINTMENT
3.
Name of student if known (if so, please attach a brief CV):
4.
Title of project:
5.
Abstract of research (in no more than 150 words):
6.
Key words (no more than six):
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7.
Confirmation of Institutional approval of application:
(a) I confirm that I have read this PhD studentship application and the associated Terms and Conditions and that if
granted, the work will be accommodated and administered in the above School.
(b) I understand that I will be bound by the Trust's conditions and I agree to notify the Trust of any significant
change in the above particulars occurring either before or during the tenure of the award if made.
HEAD OF
SCHOOL
Name
Signature
ADMINISTRATIVE
AUTHORITY
(please print)
Date
Name
Signature
(please print)
Date
Appointment
Address
Tel No
Fax No
The section above must be completed for each school involved, with appropriate signatures from Heads
of Schools and Administrative Authorities. If necessary, duplicate section 7 if supervisors from different
Schools are involved.
8.
Name, address and telephone number of the administrator who should be contacted regarding the
administration of the grant if awarded (if different from above):
Applications, one original plus 3 photocopies, should be sent to
FAO Dr Niall Horn
The Gerald Kerkut Charitable Trust
220 Hill Lane
Southampton
SO15 7NR
Please do not send them signed-for or recorded delivery; the office is not always manned and
subsequently retrieving them from the Post Office is inconvenient for the Trustees.
In addition, a copy (in MS Word) should be emailed to: gktrust@soton.ac.uk
Applications must contain signatures of all proposed supervisors (see Appendix III). In addition, where the project
involves collaboration with laboratories outside the Schools specified in section 7, the exact role of the collaborator(s)
should be clearly stated and a signed letter from each collaborator indicating their willingness to collaborate should be
enclosed with the application.
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Proposed research – please describe the project clearly, on no more than 2 sides of A4 paper, under the
following sub-headings:
1.
2.
3.
4.
Title
Background information (only include key references)
Aims and purpose of the proposed research
Outline and brief plan of investigation
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9.
Research students supervised by any of the applicants over the last 8 years (including current
students) – please give the names of all supervisors, source of funding, degree registered for, start
date and date of award of degree:
Student’s Name
Supervisor(s)
Source of Funding
Degree
Start Date
Award Date
(Insert extra rows if necessary)
10.
Number of students currently training for a PhD in the research group/division:
11.
Number of students in the research group/division awarded a PhD during the last 8 years:
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12.
Details of facilities available and other support:
i.
List specific facilities (other than basic laboratory provision) necessary to enable the proposed PhD
project:
ii.
Are these facilities already in place and operational?
iii.
Has this or a related application currently or previously been submitted elsewhere?
YES / NO (if yes, please give details and state when you expect to hear the outcome)
iv.
Is the proposed project likely to lead to patentable or commercially applicable data or apparatus?
YES / NO (if yes, please give details)
v.
Does your project include any procedure which involves patients or normal human subjects?
YES / NO
If YES, has Ethical Committee approval been obtained?
vi.
YES / NO
YES / NO / NOT APPLICABLE
Does the project involve any procedure which requires the use of experimental animals? YES / NO
If YES, have the relevant Home Office licences been obtained?
YES / NO / NOT APPLICABLE
If YES, do the licences cover the full term of the grant?
YES / NO
If YES, has the work been approved by the Ethical Review process?
YES / NO
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APPENDIX I
Please list all current grants held by the applicant(s) – this page may be duplicated if necessary
FUNDING BODY, GRANT HOLDERS, PROJECT TITLE
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
(Insert extra rows if necessary)
START/END
DATES
TOTAL SUM
AWARDED
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APPENDIX II
Curriculum Vitae of proposed supervisor(s) – please use a separate sheet for each person.
Surname
Forenames
Degrees (subject, university and date):
Current post:
Summary of previous posts (with dates):
List your most important recent research publications (up to a maximum of 10):
Date of Birth
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APPENDIX III
Full contact addresses. (Please add information for further supervisors if necessary)
PRINCIPAL SUPERVISOR – please sign where indicated
Title
Initials
Surname
Appointment
School
full address
Post Code
Email Address
Dept Tel No
Direct Tel No
Dept Fax No
Direct Fax No
I have read the Terms and Conditions and, if the application is successful, I agree to abide by them. I shall be
actively engaged in, and in day-to-day control of, the project.
Signature
SUPERVISOR 2 – please sign where indicated
Title
Initials
Surname
Appointment
School
full address
Post Code
Email Address
Dept Tel No
Direct Tel No
Dept Fax No
Direct Fax No
I have read the Terms and Conditions and, if the application is successful, I agree to abide by them. I shall be
actively engaged in, and in day-to-day control of, the project
Signature