AUSTRALASIAN UROLOGICAL FOUNDATION
Suite 512 Eastpoint 180 Ocean Street Edgecliff NSW 2027 Australia
Telephone 61 (02) 9362 8644 • Facsimile 61 (02) 9362 1433 • email:
AUSTRALASIAN UROLOGICAL FOUNDATION
UROLOGY TRAVELLING FELLOWSHIPS
Key Dates
· Applications close: 31 August 2017
· Advice re outcome: Late September 2017
· The Fellowship must be commenced in 2017 or 2018
About the Fellowships
The Australasian Urological Foundation is making several Travelling Fellowships available to full members of the Urological Society of Australia and New Zealand and accredited SET6 trainees to enable members to engage in more substantive training or research in overseas urology units.
The Fellowship will provide primary funding to the successful applicant to engage in clinical research and/or further urological training at an overseas centre in a particular area of interest to the applicant.
This field of endeavour should be seen as continuing professional development, gaining knowledge and skills that can be shared with all urologists in Australia and New Zealand. As such, successful applicants will be required to share their experience through presentations at a local section meeting or at the ASM of the Society on completion of the Fellowship. The presentation must occur promptly and no later than one year after completion of the Fellowship. Acknowledgement of the Australasian Urological Foundation must be made at the presentation.
The duration of the proposed programme must be a minimum of six months.
Eligibility
Applicants must:
· be members of the USANZ and residing in Australia or New Zealand.
· be urologists in clinical practice or involved in performing urological research or urological traineesin their final year of training.
· have been accepted into a programme of further education or experience in an overseas unit. Documentation will be required in due course from the proposed unit outlining the scope of the work and projects in which the applicant will be involved.
· have demonstrated an interest or experience in the area to be studied.
· not have received the A.U.F. grant for two years
Funding
· Grant amount: Up to maximum of $30,000
· Funding will cover fares, accommodation and any applicable fees
· Funding is primary and cannot be additional to any other travel grant.
How to Apply
· Applications close 31 August 2017
· Application to include:
o Completed application form, including:
§ Applicant contact details
§ Contact details of two referees, who must be Full Members or Fellows of the Urological Society of Australia and New Zealand
§ Declaration of other grants, scholarships or funding for the project
§ Commitment to provide a full report on completion of the programme to the Board of the Australasian Urological Foundation and make presentations at the local Urological Section meeting or Society ASM
o Curriculum vitae
o Detailed plan of study, training or continuing professional development
o Letter of acceptance from the proposed unit. (Acceptance letter may be submitted after applications close; however, the letter will be required before funding will be made available.)
· Where possible, applications (including scanned documentation) should be sent via email to .
· Applications in writing should be addressed to the Chairman of the Australasian Urological Foundation:
M J Rochford, Chairman
Australasian Urological Foundation
Suite 512 Eastpoint, 180 Ocean Street
EDGECLIFF NSW 2027
Selection Process
· All applications will be considered by a committee set up by the Board of the Foundation.
· Advice regarding the outcome of applications is expected late September 2017
· Both successful and unsuccessful applicants will be notified in writing of the outcome of their application.
UROLOGY TRAVELLING FELLOWSHIP APPLICATION /Applicant Information
Title: / First Name:
Surname:
Work Phone: / Home Phone: / Mobile:
Postal address:
City: / State: / Country
Post Code / Email address:
Category of Membership:
Current Position and Institution:
nominated References
Name of Referee 1:
Work Phone: / Home Phone: / Mobile:
Postal address:
City: / State: / Country
Post Code / Email address:
Name of Referee 2:
Work Phone: / Home Phone: / Mobile:
Postal address:
City: / State: / Country
Post Code / Email address:
Details of additional funding
Details of other grants, scholarships or funding for the project:
ADDITIONAL DOCUMENTATION
Have you attached the following documentation to this application?
Curriculum vitae ☐
Detailed plan of study, training or continuing professional development ☐
Letter of acceptance from the proposed unit. (Acceptance letter may be submitted after applications close; however, the letter will be required before funding will be made available.) ☐
DECLARATION
I, the undersigned, hereby certify that the information given above is true and correct, and, on completion of the programme, commit to providing a full report to the Board of the Australasian Urological Foundation and present at either the relevant Urological Section meeting or Society ASM. Part of the funding will be withheld until all requirements are fulfilled.
Signature of applicant: / Date: