Instructions for the applicant

·  Please complete one of these forms for each publication or other work that you wish to submit in support of your application.

·  Applicants are strongly encouraged to complete this form electronically.

·  Cite all publications that you have authored, co-authored or edited, and detail your contribution and that of all other co-authors and/or co-editors.

·  If the publication is in press, provide evidence of acceptance for publication, and/or date of publication.

·  If the manuscript has been submitted pending acceptance provide evidence of the date of submission.

An example of how to detail your contribution to a publication is given below.

-  Smith, J., Jones, F. and Roberts, S (1998) "An Analysis of Flinders University Scholarship Applications", Journal of Higher Education Research, Vol 21, No 6, pp 34-64

-  Ms F Jones and myself (Ms S Roberts) collected data from past year's applications. Ms F Jones entered these into the computer. I undertook preliminary analysis of the data and drafted sections 2 and 3 of the article.
Dr J Smith completed analysis of the data, and produced a final draft article.

Where information regarding your contribution to a publication is not provided, the Scholarships Committee may assume that your contribution was negligible.

You must provide:

·  An electronic copy of the complete publication, if it is fewer than five pages in length; or

·  The first five pages of the publication showing all bibliographic information (ISBN, title, author(s), publisher, all dates referring to copyright, publication, printing, distribution).

·  An abstract in English if the publication is in a language other than English.

For Faculty use only:

Recommended score:

Comments:

Publication Details

1 Author(s):

2 Type of Publication:

National or international conference abstract / Refereed journal article
Commercially published small monograph / Refereed conference publication
Edited book / Chapter in commercially published book
Textbook / Book containing original research/creative work
Other. Please specify below:

3 Provide a full citation and details of each author's contribution to the publication overleaf

4 Publication Title:

5 Journal/Book Title:

6 Pages:

7  Publisher:

8 Place of Publication:
9 Year of Publication:

If not yet published:

10 Date of Submission:
11 Date of Acceptance:

Provide a full publication citation and details of each author's contribution to the publication:

Certification

I declare that the information I have given in this document is true, accurate and complete.

Signature of Applicant:
Name of Applicant:
(please print)
Date: