ANNOUNCEMENT Special POGO SCOR Visiting Fellowships for on Board Training on an Atlantic

APPLICATION FORM FOR POGO-PML AMT FELLOWSHIP 2017

SECTION A: TO BE COMPLETED BY ALL APPLICANTS

1. APPLICANT INFORMATION

TITLE (Dr/Mr/Mrs/etc): FIRST NAME(S): SURNAME:

GENDER: Male Female NATIONALITY: DATE OF BIRTH:

POSITION:

INSTITUTION:

MAILING ADDRESS (PROFESSIONAL):

MAILING ADDRESS (PERSONAL):

E-MAIL ADDRESS (PROFESSIONAL):

E-MAIL ADDRESS (PERSONAL):

TELEPHONE: FACSIMILE:

Where did you hear about this fellowship?

2. SUPERVISOR AT APPLICANT’S PARENT INSTITUTION

TITLE (Prof/Dr/etc): FIRST NAME(S): SURNAME(S):

INSTITUTION:

MAILING ADDRESS:

E-MAIL ADDRESS:

TELEPHONE: FACSIMILE:

Has a letter of recommendation from the supervisor at the Parent Institutionbeen attached and the original sent by post?

Yes No

3. Background:describe the work you are currently doing and what are your training requirements.

4. Fellowship proposal: describe the training you would like to undertake as part of the fellowship, how this will benefit your current and future research, and any future collaborations that might result from the fellowship.

5. Contribution to sustained capacity building at the parent institution: describe how you intend to apply your skills and transfer your knowledge to your peers when you return from the fellowship; if you are not currently based in your home country, specify when you intend to return and if you have a job to return to.

6. CURRICULUM VITAE

Briefly highlight your academic qualifications and professional experience relevant to the training, your current position/responsibilities and career aspirations.

7. PRACTICAL DETAILS

Estimated cost of economy return international air travel from parent country to host institution: EUR

Would you require a visa for the proposed visit? Yes No

SECTION B: ONLY TO BE COMPLETED BY APPLICANTS WISHING TO FOCUS ON A SPECIFIC AREA OF WORK ALIGNED WITH ONE OF THE PRINCIPLE INVESTIGATORS FROM PLYMOUTH MARINE LABORATORY

8. PROSPECTIVE SUPERVISOR AT HOST INSTITUTION

Select from the drop-down menu:

SupervisorAndy ReesGavin TilstoneGlen TarranGiorgio Dall'OlmoRobert BrewinVas Kitidis

Is a letter of acceptance from the prospective host supervisor attached?

Yes No

9. FELLOWSHIP PROPOSAL

9.1. Title of proposed project

Please send electronic versions of completed applications and attachments by e-mail to . In addition, mail the signed original parent supervisor recommendation letterto:

POGO Secretariat

Plymouth Marine Laboratory

Prospect Place, The Hoe

Plymouth

DevonPL1 3DH

United Kingdom

Deadline: The deadline for applications for the 2017 fellowship is Friday 31st March 2017.

POGO-PML AMT Fellowship Application 2017