Professional Development Grant Application

Professional Development Grant Application

Please download this application form and complete in Microsoft Word – handwritten applications will not be accepted.

SECTION 1 –YOUR DEETS FOR OUR RECORDS

Name:
Email:
Phone:
Address:
Current position title:
Current employer:
Current employment status
(f/t, p/t, casual, contractor, etc):
ASC member since:
ASC membership type:
Current extracurricular activities (volunteer work, sports, arts):

Please also attach a one page CV with educational, workshop and employment experience.

SECTION 2 – TELL US A BIT ABOUT YOURSELF

Why did you join the Australian Science Communicators? (100 words max)
What inspires you about science communication? (250 words max)
What professional development have you undertakenin the past five years?
Where do you see yourself in another five years’ time? (100 words max)
In the space of a tweet (140 characters) describe science communication?

SECTION 3–TELL US ABOUT THE PDYOU WISH TO APPLY FOR

Please provide details of how you wish to use the grant allowance (eg. If for a conference, state conference title, dates, location, website, subject of conference)
Describe how this PD will develop, maintain or improve your current and employment-related skills and knowledge? (250 words max)
What are the expected learning outcomes for the applicant? (100 words max)
How do you plan on sharing and using what you have learnt? (100 words max)
Why areyou applying for an ASC grant to help you undertake this PD? (100 words max)

SECTION 4 – DOWN TO BUSINESS - EXPENSES

Course/ workshop fees
(proof may be required prior to award of grant)
Transport
Accommodation
Other
TOTAL COSTS

How will these costs be paid for? (Only fill out those which are relevant to you)

ASC Contribution:
Employer contribution*:
Contribution from other sources*:
Personal contribution*:

*only if applicable

SECTION 5–SIGNING OFF

Your Name (please print)
Your Signature (can be electronic)
Signature Date (dd/mm/yy)

Please note that all information on this form will remain confidential and will only be seen by those involved in the grants program (manager, reviewers and panel).

CONTACT PERSON

Dr Ian McDonald

Grants Program Manager, Australian Science Communicators

Email:

Once this application is complete please email a PDF versionto fore 11:59PMAEDT September 29, 2017.

Please note you will only be notified if you win an award, and at this stage feedback will not be provided.