Leo Fleischmann Visiting Fellowship

LEO FLEISCHMANN VISITING FELLOWSHIP IN PACIFIC ISLANDS ARTS AND MATERIAL CULTURE

APPLICATION FORM 2013 Closing date: 5pm Friday 17 May 2013

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, make sure it is signed and post it to the address below.

One original hardcopy and an electronic copy should be submitted by the closing date.

1. Title and Name of Applicant:

2. Applicant’s Institution:

3. Applicant’s Contact Details: (include telephone number and email address)

4. Project Title:

5. Description of the Research Proposal:

Include:

 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  statement of relevance to the Museum’s Science Research Strategy 2007-2012.  names and contact details of two referees.

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

1 7. Location and duration of any fieldwork or visits to other institutions during period of Fellowship:

8. (a) Proposed Fellowship Budget: (living costs up to $800 per week, travel, research expenses etc)

Item Cost

Total Cost $

(b) Brief justification of budget:

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

b) Services: (e.g. photography, X-ray, electron microscopy, etc) c) Other: (eg laboratory space, office space, access to equipment)

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

2 Signature of Applicant:

______Date:

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

“I certify that this institution supports this project.”

______Date: Position:

Name of the Australian Museum staff member you have discussed your research proposal with:

Applications should contain:

 Completed application form (not exceeding five pages)

 Your CV which should cover: o applicant's name, address, phone and fax numbers, and an email address if available. o citizenship status. o education summary, with tertiary qualifications (degrees/diplomas, when/where conferred). o list of relevant awards and honours. o experience relevant to the project, including prior fieldwork where this is required for the project. o list of publications.

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

Marcela Pacheco Office of the Assistant Director, Research & Collections Australian Museum 6 College Street SYDNEY NSW 2010 Australia Email: [email protected]

Please check website for application closing date.