<p> The Royal Australasian College of Physicians Paediatrics & Child Health Division</p><p>APPA TRAVELLING SCHOLARSHIP CRITERIA</p><p>The Paediatrics & Child Health Division of the Royal Australasian College of Physicians offers an annual Travelling Scholarship to be administered by the Board of Censors (Paediatrics). The Travelling Scholarship is intended to help the exchange of knowledge and friendship between Australian/New Zealand paediatricians and colleagues in the South East Asian Region. Applicants must be resident in a country whose paediatric professional association is a member of the Asian Pacific Pediatric Association (APPA). [Excluding Australia and New Zealand.]</p><p>1. Applications will be forwarded to the Secretary of the member society of APPA in the country of residence of the applicant.</p><p>2. Each member society of APPA may forward one application to the Secretary-General of APPA who will forward the applications from all member societies to the Paediatrics & Child Health Division.</p><p>3. The Scholarship will be awarded by the Board of Censors (Paediatrics) of the Paediatrics & Child Health Division.</p><p>4. The successful applicant will be a young paediatrician at a relatively early post-residency stage of his/her career who wishes to obtain further training and experience in a selected area of paediatrics at an appropriate training center in Australia or New Zealand.</p><p>5. The Scholarship is valued at $AUDI 12,000. The Division has undertaken to give an additional amount of up to $AUD 6,000 to match dollar for dollar any funds which the candidate is able to obtain within his/her own country, once the Scholarship is awarded.</p><p>6. The Scholarship is expected to go towards living expenses for the successful applicant while in Australia/New Zealand. The candidate is responsible for purchasing his/her own airfare.</p><p>7. The duration of the Scholarship will generally be for a period of at least 12 months, not exceeding 24 months, following which the trainee must return to practice in the country of origin.</p><p>8. Confirmation from the successful candidate that he/she has been accepted into a program in Australia/New Zealand must be received within 6 months from notification, with the expectation of commencing in the program within 12 months. In the event that this is unachievable, written advice from the successful candidate detailing the reasons for the delay in commencement date.</p><p>If notification is not received, the Scholarship may be awarded to an alternative candidate.</p><p>9. The Board of Censors (Paediatrics) will take into consideration:</p><p> a. The appropriateness of the proposed training program to the needs of the applicant and his/her country of origin. b. The ability of the applicant to communicate in English. 10. Applications will only be considered if typed on the application form and accompanied by a full curriculum vitae.</p><p>It will be beneficial if the applicant has:</p><p>* defined the aims and objective of the proposed program  indicated how this program will benefit their home country  made prior contact with a centre/hospital in Australia/New Zealand concerning the proposed period of study/training;  determined who will supervise the period of training/study in Australia/New Zealand;  fully considered the available resources in Australia/New Zealand and is confident that the aims and objectives of the proposed training/study are able to be achieved during the proposed period.</p><p>Detailed information relating to the above should be included in the application form. The Royal Australasian College of Physicians Paediatrics & Child Health Division</p><p>APPLICATION FORM APPA TRAVELLING SCHOLARSHIP (Please enclose a detailed curriculum vitae and complete all sections)</p><p>1. SURNAME: ……………………………………………………………………………………….</p><p>GIVEN NAMES: ………………………………………………………………………………….</p><p>2. MALE FEMALE 3. DATE OF BIRTH</p><p>DAY ____ MTH ____ YR ______</p><p>4. COUNTRY OF 5. NATIONALITY: BIRTH: ______</p><p>6. MARITAL STATUS MARRIED SINGLE</p><p>7. HOME ADDRESS: ……………………………………………………………………………..</p><p>……………………………………………………………………………..</p><p>……………………………………………………………………………..</p><p>8. PROFESSIONAL …………………………………………………………………………….. ADDRESS: ……………………………………………………………………………..</p><p>……………………………………………………………………………... 9. ACADEMIC QUALIFICATIONS</p><p>DEGREE CONFERRING YEAR INSTITUTION CONFERRED</p><p>UNDERGRADUATE</p><p>POSTGRADUATE</p><p>10. POSTGRADUATE APPOINTMENTS (Detail all appointments held)</p><p> a. Previous Position Held</p><p>HOSPITAL/ POSITION COMMENCEMENT FINISING LENGTH OF UNIVERSITY DATE DATE APPOINTMENT</p><p> b. Present Appointments</p><p>HOSPITAL / POSITION DATE UNIVERSITY COMMENCED 11. SCIENTIFIC PUBLICATIONS (If insufficient space, attach list)</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>12. FIELD WHICH YOU WISH TO STUDY</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>13. CENTRE(S) WHERE STUDY WILL BE UNDERTAKEN (If Known)</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>14. WHO WILL SUPERVISE WORK? (If known) Indicate if they have agreed in writing.</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>…………………………………………………………………………………………………. 15. AIMS OF TRAVEL TO AUSTRALIA/NEW ZEALAND (Include details of course of study, position to be held or details of research projects if any of these are known)</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>16. HAS APPLICATION BEEN MADE FOR ANY OTHER FINANCIAL SUPPORT FOR THE STUDY PERIOD?</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>17. WHAT DO YOU SEE AS THE BENEFIT TO PAEDIATRICS IN YOUR COUNTRY OF ORIGIN ARISING FROM YOUR STUDY IN AUSTRALIA/NEW ZEALAND?</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>18. WHAT FORMAL TRAINING AND EXPERIENCE DO YOU HAVE WITH ENGLISH?</p><p>Reading: ………………………………………………………………………………………</p><p>…………………………………………………………………………………………………</p><p>Spoken: ………………………………………………………………………………………</p><p>………………………………………………………………………………………………… 19. DO YOU INTEND TO STAY LONGER THAN THE 12 MONTHS STAY PROVIDED FOR BY THE SCHOLARSHIP?</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>20. NAMES AND ADDRESSES OF THREE (3) REFEREES</p><p>(i) .…………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>(ii) .…………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>(iii) …………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>…………………………………………………………………………………………………. REFEREES FORM</p><p>THE PAEDIATRICS & CHILD HEALTH DIVISION APPA TRAVELLING SCHOLARSHIP</p><p>NAME OF THE CANDIDATE: …………………………………………………………….</p><p>REFEREES STATEMENT</p><p>(i) Please comment in detail on this candidate’s ability to communicate in English.</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>…………………………………………………………………………………………………. </p><p>(ii) Do you regard the proposed study as appropriate to the candidate and your country’s requirements?</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>(iii) What are the prospects for the candidate utilising his experience on return to his own country?</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>GENERAL STATEMENT AND COMMENTS ABOUT CANDIDATE (Use separate sheet if necessary)</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p><p>………………………………………………………………………………………………….</p>