North Star Avenue
Swindon, SN2 1EU EPSRC POLICY PLACEMENT
Telephone No. 01793 411500
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
Title Initials Surname Date of birth
DD MM YY
DEPARTMENT AND INSTITUTION of applicant and administering institution for all
Official Tel. Email:
3. TITLE OF FELLOWSHIP OPPORTUNITY APPLYING FOR
4. NAME OF HOST ORGANISATION
Department of Environment, Food and Rural Affairs (Defra)
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
8. FINANCIAL DETAILS
Travel and subsistence
Estate costs(if applicable)
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 firstname.lastname@example.org by 4.00pm on 13