Fellowship Application Form

Institute of Liberal Arts and Sciences
FELLOWSHIP SCHEME APPLICATION FORM 2018-19
This form should be completed jointly by the Fellowship applicant and Keele academic staff member who will partner the applicant and host the visit. Once complete, please submit the following documents
PDF version of the Fellowship Application Form
CVs for both the Fellowship applicant and Keele Host
Fellowship Proposal Document
To the ILAS Manager Ms Jo Flynn by the deadline October 30th 2017
1. Details Keele Academic Partner
Title
Surname
First Name
School
Position
Email address
Telephone Number
2. Details Fellowship Applicant
Title / School / Email address
Surname
First Name
Address
Institution of Employment
Address
Position held
Email address
Telephone Number
Do you require a visitor’s visa to take part in this scheme?
3. Contact Details : Heads of School/Department
The Institute will contact Heads of School/Department of both the Keele Host academic and the Fellowship applicant. This is in order to ensure that there is support for the activity and the commitment involved and that this can be accommodated on both sides.
(a) Keele Host Academic
Head of School - Details
Title
Surname
First Name
Email address
Telephone Number
Name and address of School
(b) Fellowship Applicant
Head of School/Department - Details
Title
Surname
First Name
Email address
Telephone Number
Name & address of School
/ Department
4. Fellowship Proposal Title
5. Fellowship Proposal Document
Please attach a detailed description of the work to be undertaken during the Fellowship (500- 1000 words).
This should include
- Project title
- Overview of the project
- Project aim
- Planned activities to be undertaken and planned outcomes
- Expected benefits of the work to the scholarship and for both applicants and the partnering institutions
- Longer term aspirations for the partnership, including where applicable, specific future joint grant applications and the potential scope and scale of these.
6. If the Fellowship proposes to build upon a previous established collaboration between the Keele host academic and the applicant please explain how the Fellowship will further the relationship and potential outcomes (200 words)
7. Please outline your longer term aspirations for the partnership, how you expect to sustain the collaboration following the Fellowship and, where applicable, specific future joint grant applications and the potential scope and scale of these.
8. Fellowship Timings
We are inviting applications for Fellowships to be undertaken in the period 2018-9. This may be an extended visit or a number of shorter visits. The maximum length of the Fellowship is 3 months in total, for which an allowance of up to £5,000 is available. This may be used to cover travel to and from the University and subsistence once here (See Section 9). The maximum award is £5,000 and the funding will be calculated on a pro-rata basis and confirmed as part of the Fellowship offer.
Please outline the proposed planned visits(s) to Keele as part of the Fellowship. It is expected that visits will be completed by September 30th 2019.
Number of days / Proposed Start / End
Visit 1
Visit 2
Visit 3
9. Support Requested
The maximum funding award is £5000 and this will be calculated and agreed as part of the Fellowship offer. This can be used to cover travel, subsistence, visa costs, health insurance and registration fees for conference and workshops. It does not cover salaries, the purchase of equipment, publication costs, licenses or consumables. Funds will be paid to the applicant by ILAS against receipts, up to the maximum awarded. Further guidance on what may be claimed for specific items (e.g travel costs) is provided by the University and may be obtained from the ILAS Manager.
For guidance, please provide an estimated budget for the award spend.
Return fare (standard class) to Keele University
Travel at the University e.g. to other UK Institutions, conferences etc.
Cost of accommodation
Daily subsistence needs
Cost of Visa, if required
Health Insurance, if required
Other (please specify)
Total (If this is greater than the maximum funding award , please state how additional costs will be met)
10. Accommodation Needs
To enable us to advise you about accommodation, please indicate if you expect to be accompanied by a partner and/or children.
11. Referee – Fellowship Applicant
Please provide contact details for a referee who is familiar with your current work and able to comment on your application. Please ensure that they are informed and will be available to provide a timely reference. This will be sought after the closing date.
Referee
Title
Surname
First Name/s
Institution
Position
Address
Email address
Telephone Number

12. Support

If you require any specific support or adjustments in order to undertake this Fellowship, please provide details below.

Fellowship Application Form

Please submit completed applications, including Fellowship Application Form, Fellowship Proposal Document and CVs to Jo Flynn at by Midday on Monday October 30th 2017