Copyright Australian Museum, 2001

AUSTRALIAN MUSEUM RESEARCH INSTITUTE VISITING COLLECTIONS FELLOWSHIP APPLICATION FORM 2017

To complete the application form: 1. Open and fill in the electronic Word file 2. Save the completed form and attach it to an email addressed to: [email protected] 3. Print out the completed form, obtain relevant signatures and post it to the address below along with other required documentation.

One original hardcopy and one electronic copy should be submitted by 5pm Friday 22 April 2017.

1. Title and Name of Applicant

2. Applicant’s Contact Details

Postal address: Email address: Phone number: Institution:

3. Project title

4. Period for which Fellowship is sought (approximate dates and total length, including how much time will be spent at the Australian Museum)

5. Location and duration of any field work or visits to other institutions during period of Fellowship

1 6. Is field work planned at the Australian Museum’s Lizard Island Research Station? (bookings must be made several weeks in advance)

7. Does the Fellow intend to have an additional person(s) (eg spouse, student, etc) involved in the research project or in other areas of the Museum during their stay? (if yes, give details)

8. Proposed Research Contribution to AMRI Objectives (double left click on box to “check or uncheck”) Please refer to the Australian Museum Science Strategy 2014 – 2017. Applications should address AMRI research priorities.

AMRI Research Priority Explain how the priority will be addressed 1. Use of our research and collections expertise to understand and meliorate the environmental impacts of climate change on biodiversity

2. Contribute to the understanding and

management of biosecurity threats

3. Discover and understand biodiversity to

inform effective animal conservation

4. Apply wildlife genomics to solve key

problems

5. Generate knowledge to maximize benefits from Australia’s geological and biological resources

6. Foster understanding and appreciation of cultural differences for a more socially inclusive society through our anthropological and archaeological research.

Objectives, Methods and Outcomes of Proposed Research Maximum 3 pages (not including references) Including statement of the research problem; how it will be carried out.; what progress has already been made; how long the project will last (including a schedule); what outcomes are expected, including publications.

2 Budget An itemised budget for the way in which you propose to use the requested money in your research including DNA services with brief justification. (For molecular biology studies, please indicate number of samples and number of genes) For DNA costs please contact Dr Greta Frankham, [email protected]

Item Cost

Total Cost $

9. Equipment or services required from Australian Museum for Fellow (indicate if equipment can be supplied by you if not available) Equipment

Services If you plan to use the Museum’s DNA facilities or the SEM lab please include these as a line item in your budget. For DNA costs please contact Dr Greta Frankham, [email protected]

Other (eg laboratory space, office space, access to equipment)

10. Names and contact details of two referees These cannot be the same as the Project Leader, Collection Manager or Branch Head

3 APPLICANT TO COMPLETE

Signature of Fellowship Nominee:

______Date:

Signature of Head or delegated authority of Applicant’s institution (if appropriate):

“I certify that this institution supports this project.”

______Date: Position:

AUSTRALIAN MUSEUM STAFF TO COMPLETE

Signature of relevant Collection Manager: (Note: The Collection Manager is responsible for notifying the SEM, DNA or relevant collection manager to advise them of the scope work and start date of the Visiting Fellow. The Collection Manager should also accompany the Visiting Fellow to these labs/collections on the Visiting Fellow’s arrival.)

______Date:

Position:

Signature of relevant Branch Head:

______Date:

11. Other documents that should be submitted with your application  Statement on letterhead from the applicant’s employer certifying that his or her salary or stipend and associated expenses will be paid by that institution during the tenure of the fellowship  Statement of support from an Australian Museum Research Institute (AMRI) staff member  Applicants CV (including a list of publications)

4 One (1) original hardcopy and one (1) electronic copy of the application should be sent to:

Alexandra Nuttall AMRI & External Partnerships Support, Science & Learning, Australian Museum Research Institute Australian Museum 1 William Street SYDNEY, NSW 2010 Australia Phone: (+612) 9320 6248 Email: [email protected]

The closing date for applications is 5pm Friday 22 April 2017.