Student Application

iPREP BIODESIGN ROUND 1 2021

STUDENT APPLICATION FORM

Please have the following ready for this application:

Your current CV
Reference letter from your Supervisor

Please read the Student Guidelines before completing your application.

Applications close: Wednesday 27 January 2021

Placement period: Tuesday 2 March - Wednesday 21 April 2021

If you are shortlisted a 1 minute video pitch will be required.

Please contact or 6304 2069 for more information.

Part A: Applicant's Information

First name

Last name

Date of birth

Preferred email address

Home address

Phone

University

School

Student number

Are you currently receiving a scholarship? If so, which scholarship and for how long will you be receiving it?

Are you enrolled as a domestic or international student?

Domestic

International

Are you applying as a (please select one):

Late-stage PhD candidate (submitted or about to submit thesis - international and domestic candidates eligible to apply)

Domestic-enrolled PhD candidate at pre-submission stage (consumed at least 2 EFTSL or 2 years of candidature - domestic only candidates eligible to apply).

Note - Domestic-enrolled PhD candidates will need to gain approval from:

ECU (your School's Associate Dean, Research)
Notre Dame (your School's Associate Dean, Research)
Curtin (the Director of Graduate Research and your School's Postgraduate Coordinator)
Murdoch (the Dean/Manager of the Graduate Research office)
UWA (Graduate Research School). UWA PhD domestic pre-submission students are ineligible to apply if in the last 6 months of candidature. Contact UWA GRS for more information.

iPREP WA will forward your application to gain the approval, and you will be notified of the outcome.

Have you submitted your thesis for examination?

Yes

If yes, please enter your submission date below. If you have not submitted your thesis, please upload a letter of support from your Supervisor stating that you are on track to submit before Tuesday 16 February 2021. This is in addition to your Supervisor reference letter.

Yes, thesis was submitted on:

No, thesis will be submitted on:

Upload Supervisor letter of support.

Upload File

Upload supported file (Max 15MB)

Are you available to participate in the first stage induction on Friday 5 February 2021 and the second stage induction on Wednesday 24 February 2021?

Yes

Are you available on a full time basis to complete the seven-week placement from Tuesday 2 March - Wednesday 21 April 2021?

Yes

Are you currently in paid employment?

Yes

If currently in paid employment please provide your job title and working hours below.

Please select your preferred mode/s of participation in the seven-week placement below:

Virtual/ remote work only

In person/ in the workplace

Combination of remote work/ in-person

Part B: Applicant's Research Experience and Employability Skills

Thesis title (max 20 words):

Thesis summary (maximum 75 words):

Other research experience (max 75 words):

Please provide a summary of your existing skills, attributes and experiences that you foresee as relevant to an industry engagement project (maximum 150 words):

Please describe the skills you hope to develop if you are successful in your application and how you anticipate this will benefit your future career (maximum 150 words):

Part C: Applicant's CV and Supervisor Reference

Please upload current resume (max 2 pages), containing your relevant employment and educational history.

Upload File

Upload supported file (Max 15MB)

Please provide Supervisor details below as a referee to support your application.

Referee name

Referee email

Referee position title and organisation

Referee phone

Please upload a letter from your referee supporting your application. Comments on the student's ability to work well in a team, whether the student would be a good ambassador for their university and any other relevant skills or research that would support their iPREP application should be included.

Upload File

Upload supported file (Max 15MB)

Part D: Applicant's Declaration

I agree to abide by the Conditions of Participation in iPREP Biodesign:

As a doctoral candidate participating in iPREP Biodesign, I understand that I remain subject to the policies, rules and regulations of my university.
I understand that my university may vary or cancel any decision it makes if the information I have given is incorrect or incomplete and that I may have to repay any award monies.

I declare that the information provided in the application form and any attachments is complete, true and correct.

I also undertake to:

accept financial responsibility for all of my personal expenses not covered by the scholarship, if applicable, during the period;
undertake the project according to any ethical requirements;
agree to intellectual property and confidentiality requirements if specified by the industry partner; and

I understand that failure to abide by these conditions may result in disciplinary action by my university.

I agree to the terms & conditions

Name

Date