AMPLIFY FESTIVAL 2015 BRIGHT SPARKS ENTRY FORM

Transcription

AMPLIFY FESTIVAL 2015 BRIGHT SPARKS ENTRY FORM
AMPLIFY FESTIVAL 2015 BRIGHT SPARKS ENTRY FORM
1
2
About you
About your
project
3
Your supporting
evidence
ABOUT YOU:
Describe yourself in the length of a tweet: (140 characters) *
Maximum Allowed: 140 characters.
Contact Details:
Title *
Name *
First
Last
Position *
Institution or Organisation: *
Phone Number (work) *
Mobile Number *
Email *
Twitter*
Bright Sparks Application Form
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Address *
Street Address
Address Line 2
City
State
Code
Country
Your Qualifications:
(e.g. Bachelor of Medical Science - University of Sydney, 2009)
Qualification 1: *
Qualification 2: *
Qualification 3: *
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Bright Sparks Application Form
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ABOUT YOUR PROJECT:
This entire section plays a vital role in assessing your application. We want to see if
you can describe your work and communicate its relevance using everyday language
to a lay audience. Avoid complex terminology / jargon – i.e. imagine you are
explaining what you do to a stranger you just met at a BBQ
Project Title/Tagline:
*Think newspaper headline (less than 8 words)
Project Summary in Basic Layman Terms:
This is a vital section of the application assessment criteria –briefly tell us about your
project or idea. Inspire us with your story and spark our curiosity to read on for further
details. *
* field (less than 100 words)
Project Description: (overall less than 300 words)
What are you trying to achieve or your current results?
* field (less than 100 words)
Why does your research matter?
Why it is relevant to a general or business audience and why should we care?
* field (less than 100 words)
How will your research transform or benefit society?
* field (less than 100 words)
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Bright Sparks Application Form
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Show Your Supporting Documentation (and attachments)
Please provide evidence of internal/external review to support your application.
This may be from your PhD supervisory panel/ higher degree research coordinator/
Chief Executive or GM of your organisation.
You will be asked to upload your evidence as a single document at the end of this
form.
Evidence of Peer Review:
Briefly list the types of evidence you will attach in support of your application.
e.g.
Certificate of candidature
Conference papers/presentations
Publications submitted or in press
Patents
Research awards
Internal reviews by academic staff
Maximum Allowed: 300 characters.
Please upload your supporting evidence as a single document *
BROWSE
Publications/Papers:
List titles of any recent and relevant publications (including those submitted or in
press), conference presentations etc
Author/s (Year). Name of Paper, Tile of Publication, Relevant Pages
Author/s (Date &Year). Title of Paper. Name of Conference, Venue
Publications/Paper 1:
Publications/Paper 2:
Publications/Paper 3:
Publications/Paper 4:
Bright Sparks Application Form
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Referees:
Please provide the contact details of at least 2 referees who can verify details
of your enrolment and the scientific rigor of your project (e.g. your PhD
supervisor/s, employer if they are sponsoring your research etc.)
Referee Name 1 *
First
Last
Position *
Institution or Organisation: *
Phone Number (work) *
Email *
Referee Name 2 *
First
Last
Position *
Institution or Organisation: *
Phone Number (work) *
Email *
Bright Sparks Application Form
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Collaborators:
List any individuals or organisations who need to be acknowledged?
Collaborator Name 1 *
First
Last
Institution or Organisation: *
Collaborator Name 2 *
First
Last
Institution or Organisation: *
Personal Authorisation
I have read and understood the terms and conditions of participation and wish
to submit an application for review.
I am willing to commit to, and actively participate in, the required training and
performance dates.
Submit
Bright Sparks Application Form
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