Please Indicate If This Application Is for (Please Tick)

Please indicate if this application is for (please tick)

a fellowship
participation in one of the writeshops
a fellowship AND a place in writeshop

1. Personal and contact information

·  Please provide up-to-date and correct contact information. If your application is successful, we will contact you by email, so please make sure that you provide a valid email address that you check regularly.

Please note that the panel reserves the right to offer either a fellowship or participation in one of the writeshops, based on what they feel will most benefit your chances of publication.

Do NOT convert the Word file to PDF format – submit it as it is in Word format.

Title
(please delete as appropriate) / Dr / Ms / Mr
Family name
Given names
Date of birth
Gender
Nationality
Country of Origin
(please delete as appropriate) / Afghanistan, Bangladesh, India, Nepal, Pakistan
Address of residence
Institutional address
(Please provide for primary and secondary institution as appropriate)
Phone
Email

SICRISA, ‘Application Form

2. Education and Qualifications

Year / Qualification / Subject

3. Current Employment

Date started / Role

4. Relevant Research Activities

Title / Brief description / Status and Dates

5. Broad Subject of Research (please tick)

Natural Sciences
Social Sciences
Interdisciplinary

6. Broad Area of Research:

Climate Change Assessment
Climate Change Adaptation
Climate Change Mitigation
Climate Change others - please specify:

SICRISA, ‘Application Form

7. Publications

Have you published earlier: Yes/ No (please delete as appropriate)

If yes, but not in international journals of high rank or in national journals or books, attach a copy of your most representative paper as evidence of your suitability.

Selected Publications (please list no more than 4 in order of importance).

S No. / Year of Publication / Publication

8. Short biographical summary (not more than 200 words)

SICRISA, ‘Application Form

9. Your work

Please give a description of your work, which is leading to the proposed publication, including:

·  the research question or hypothesis that underlies the work,

·  an explanation of the data involved (if appropriate to the topic)

·  an explanation of the methodology used

·  an explanation of how the proposed publication relates to other plans for outputs from the work

Please limit your response to 500 words.

SICRISA, ‘Application Form

10. Abstract of your proposed paper

Please provide an extended abstract of the paper you are proposing to use in the fellowship / writeshop. This should relate to already existing work as outlined above, not a new topic.

Please limit your response to 500 words.

SICRISA, ‘Application Form

11. Collaborative work

We recognize that many authors will be parts of a team or may be writing a paper together with others. However, the fellowships and writeshops are not offered to teams or multiple authors, and applicants should realise that they cannot form a team to make an application.

Is your proposed paper part of an ongoing collaboration with other authors? (please tick)

yes
no

If yes, please provide a list of other authors and their institutions, and percentage of their effort in the project/ proposed paper.

SICRISA, ‘Application Form

12. Justification

Please explain why you are applying for a fellowship / writeshop place and how your participation (if successful) would support your work. Please include an explanation how the participation in the fellowship / writeshop would improve your paper.

Please limit your response to 500 words.

SICRISA, ‘Application Form

13. Timescale

Please provide a timescale for completion and submission for publication of your proposed paper. This must include:

·  any know factors that may constrain or interrupt your progress (e.g. planned holidays, research visits or other travel)

·  for applications for fellowships: the period when release from normal work activities will take place (with start and end date and no longer than one month)

·  writeshops will take place at in August / September and October / November 2012 (exact dates to be confirmed). Please indicate if there are dates that you are not available during those periods

14. Guidelines for completion of the application form:

Please

·  read the selection criteria carefully, as we cannot consider any exceptions.

·  fill in all sections, if a section is not applicable to you, please indicate this in the box. Section 9. needs only to be completed by candidates applying for a fellowship.

·  add extra lines if you need to.

·  do not go over the maximum words where requested. If you do, your text will be cut off at the word limit and anything else will not be considered in your application.

·  Do NOT convert the Word document to a PDF file.

SICRISA, ‘Application Form