PhD Scholarship Application Form

AGILENT PhD SCHOLARSHIP

The Victor Chang Cardiac Research Institute is proud to support and invest in the future of PhD students, and our objective is to develop the next generation of researchers.

The Agilent PhD Scholarship is partially supported by Agilent Technologies. Agilent provides a PhD Scholarship specifically to support metabolomics-based research within the Victor Chang Institute’s newly established Innovation Centre.

The successful candidate will receive up to $36k per annum (inclusive of RTP or equivalent scholarship) for three years.

ELIGIBILITY

·  A B.Sc. (Honours, Class I or II) in a biochemistry related discipline or equivalent is essential.

·  Only full-time RTP (or equivalent) University Scholarship holders, or applicants with a track record competitive for an RTP (or equivalent) Scholarship, are eligible to apply.

·  This project requires solid background knowledge in analytical chemistry or biochemistry, ideally with experience in mass spectrometry.

The Victor Chang Institute reserves the right not to award a scholarship if applicants are not regarded to be of the required standard.

COMPLETION AND SUBMISSION OF APPLICATION FORM

Once you have applied for your PhD & RTP (or equivalent) you may then submit an application for consideration.

§  The first two pages provide information only and should not be submitted with the application;

§  Complete ALL sections (make a note “N/A” in sections that are not applicable);

§  To apply, students should send their completed application form, CV and academic transcripts to Human Resources via email -

CLOSING DATE: 30 November 2017

APPLICANT DETAILS

Personal Details
Family Name:
Given Names:
Preferred Name: / Title: / qMr qMrs qMiss qMs q Dr
Date of Birth: / / / / / Country of Birth:
Visa Status: / q Australian / NZ Citizen / q Australian Permanent Resident
q Other, please specify:
Address
Home Address:
Suburb: / State: / Postcode:
Postal Address (if different from above):
Home Ph: / ( ) / Mobile Ph:
Research Higher Degree Details
Course of Study
Enrolling Institution (including Department)
Candidature Start Date
Candidature End Date
Scholarship Details
Please also attach a copy of the letter of offer from your university confirming scholarship award.
Type of Scholarship
(RTP etc.)
Full Title of Research Project
Scholarship Start Date
Scholarship End Date

TRACK RECORD

Academic Transcripts
Please attach a certified copy of your full academic transcript including undergraduate and postgraduate courses.
Academic References
Please attach a copy of your academic references.
Research Related Experience
Provide details of any research related experience in date order beginning with the most recent
Role / Organisation Name / Department / Start Date / End Date
List of Publications
§  Please provide the full reference for each of your publications.
§  Number publications chronologically, listing the most recent publication first
Scientific/Medical Conference Attendance
§  Please provide details (name of conference, year, location) of any scientific/medical conferences you have attended.
§  Number conferences chronologically, listing the most recent publication first.
§  If you presented at the conference, please include details (title and type of presentation) of your presentation.
Awards
§  Please list any academic awards you have received e.g. (Deans Merit list, Faculty Award etc.)
Memberships
§  Please list any relevant memberships
Other relevant information
§  Please provide details of any other contributions you feel are relevant to this application. For example, any patents on which you are named, guidelines that you wrote/contributed to, polices that you influenced, etc.

CERTIFICATIONS

CERTIFICATION BY APPLICANT

I certify that all details given in this application are correct, and agree to abide by the conditions of the PhD Scholarship. I have enclosed a certified copy of my most recent academic transcript.

Signature / Date

Agilent – October 2017 Page 3 of 4