2017National Parliamentary Fellowships Program: India

2017NATIONAL PARLIAMENTARY FELLOWSHIPS PROGRAM: INDIA

APPLICATION FORM

Personal Details

Family Name:
Given Names:
Date of Birth (dd/mm/yyyy): / // / Male / Female
Term Address:
Permanent Address:
Contact Number:
Email Address:

I confirm that I am an Indian Citizen

Emergency Contact:

Full Name:
Relationship to you:
Contact Number:
Email Address:

Academic Details:

What is/was your current or most recent university, degree program, and major?

Referees Details:

Please list the details of two referees below; at least one referee must be academic:

Full Name:
Position:
Contact Number:
Email Address:
Full Name:
Position:
Contact Number:
Email Address:

Statement of Purpose:

Please write a brief statement of purpose detailing your reasons for applying to theNPFP. This should include what area(s) of foreign policy legislation interest(s) you the most and why, what you hope to gain from a placement with a member of the Australian Parliament, and the relevance of the NPFP to your academic or professional goals. (maximum 750 words):

Other Information:

Please list any other leadership experience and/or extra-curricular involvement that may be relevant to your application (eg Work experience, volunteer activities, community involvement, sporting/cultural achievements) (maximum 300 words):

Proposed Research Topic:

Title of proposed research topic (maximum 25 words):
Please outline your proposed research topic in 100 words or less. Highlight the relevance and importance of your proposed topic, and how your time in Australia will inform research for the topic (maximum 100 words):

Attachments Checklist

Academic transcript (please provide transcripts for all current and/or previous tertiary study)

Proof you are meeting ANU English language requirements as outlined under:

Your resume

Declaration

I have attached an official copy of my academic transcript (please provide transcripts for your most recent and previous tertiary study)

I understand the requirements of the program, as outlined on the NPFP flyer

The NPFP may contact the two referees listed above

My most recent academic grades were a Distinction/A Level average

I hold an Indian passport that has at least 6 months validity

Signature: ______

Printed Name:
Date: / / /20

Submit your Application

Applications are to be submitted electronically as a single Adobe Acrobat PDF file (including the signed Application Form and requested attachments) in an e-mail addressed to .

Please ensure you have saved or printed a copy of your application for your own records.

All applications must be received before 5 pm India Standard Time, 29 August 2016.