EPSRC Policy Placement Scheme by HC12091105376

VIEWS: 0 PAGES: 2

									                        Polaris House
                        North Star Avenue
                        Swindon, SN2 1EU              EPSRC POLICY PLACEMENT
                        Telephone No. 01793 411500
                                                                      SCHEME

                                                          Policy Fellowship Placement

COMPLIANCE WITH THE DATA PROTECTION ACT 1998
In accordance with the Data Protection Act 1998, the personal data provided on this form will be
processed by EPSRC, and may be held on a computerised database and/or electronic files.
Further details may be found in the guidance notes.

                         Date:                                 Reference No.
EPSRC USE ONLY
                         Acknowledged:


1.      APPLICANT
Title        Initials          Surname                                   Date of birth



                                                                         DD      MM      YY

Post
Held


        DEPARTMENT AND INSTITUTION of applicant and administering institution for all
2.      correspondence
        Department

        Institution

        Full address


        Official Tel.                                 Email:
        Number
        (including STD
        Code)



3.      TITLE OF FELLOWSHIP OPPORTUNITY APPLYING FOR




4.      NAME OF HOST ORGANISATION
        Department of Environment, Food and Rural Affairs (Defra)




                                                                                               1
5.    HOW WILL YOUR KNOWLEDGE AND EXPERIENCE BENEFIT THE PROJECT YOU ARE
      APPLYING FOR? (Up to 1,000 words.)



      DURATION Proposed                                Period requested             Months
6.    start date
                               D   D   M   M   Y   Y

      Proposed end date



7. YOUR CURRENT MAIN RESEARCH / POLICY DISCIPLINE

Main discipline



8. FINANCIAL DETAILS



SUMMARY

Salary

NI/Superannuation

Travel and subsistence

Indirect costs

Estate costs(if applicable)

TOTAL



9. IS THERE ANYTHING ELSE YOU NEED TO TELL US IN SUPPORT OF YOUR
APPLICATION? (Up to 200 words)




10. Additional information – this will not be used in the assessment of applications:
a) Where did you hear about this scheme?



b) Are you currently or have you been EPSRC funded?




                                                                  [End of Application Form]

Please send your completed application form to policyfellowships@epsrc.ac.uk by 4.00pm on 13
April 2010.


                                                                                             2

								
To top