/ UNIVERSITY OFSTELLENBOSCH
HEALTH SCIENCES FACULTY /

Subcommittee c of the research committee

APPLICATION: TERM POST FOR RESEARCH ASSISTANCE
IN THE ALLIED HEALTH PROFESSIONSFOR 2012

(Please complete electronically)

  1. Please note the guidelines for term posts(attached).
  2. All sections must be filled out in the form. Please lengthen the form electronically as needed.
  3. Please attach onlyyour research outputs over the last 5 years, including journal articles, conference proceedings, etc. with comprehensive references where applicable.
  4. The applicant needs to submit the completed application form to her/hisHead of Division or Department for recommendation, and the application is to be sent to RDSD with a confidential recommendation from the head. It may be e-mailed to Dr Tania Brodovcky ().

Contact persons for enquiries and submissions:

Dr Tania Brodovcky ()

Mrs Sasley Beukes ()

Research Development and Support Division (RDSD); 5th Floor, Education Block

Closing date for applications: Monday,26March 2012

(no late applications will be accepted)

APPLICATION: TERM POST FOR RESEARCH ASSISTANCE IN THE ALLIED HEALTH PROFESSIONS

A.APPLICANT

Surname / Initials /

Title

Department / E-mail
Position / UT number
Appointment (Full time permanent/ contract)
(NB: If on contract, your appointment must be at least for the duration of this award)

B.PROJECT SUMMARY

Project title
Start date / Expected end date
Ethics approval obtained (YES/NO)
If YES, please provide number and expiry date (MM/YYY)
If NO, briefly outline the steps and timeline that will be taken to obtain ethics approval

C.BRIEF ProjeCT DESCRIPTION. (NB: To ensure a focused approach, this post must be linked to a specific research project/programme)

D.Source of project running funds(e.g. a grant from the MRC, NRF or other funding agency)

E.APPLICANT’S SIGNATURE(Please note:By signing this form, successful applicants undertake to comply with the specific requirements of this award, and the rules and regulations (HR and other) of the University of Stellenbosch)

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SIGNATURE OF APPLICANTDATE

(Please submit this form to your HOD/Chair/Director for a confidential recommendation)

F.confidentialrecommendation by hod/chair/director.

(Please indicate your support (or not) of this application clearly; provide any appropriate explanation or motivation; please sign and date this form; please submit to RDSD by Monday, 26 March 2012):

Please tick one:

Strongly supportedSupportedNot supported

  

Motivation:

…………………………………………. ………………………………..

NAME (IN TYPE SCRIPT) POSITION

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SIGNATURE OF HOD/CHAIR/DIRECTOR DATE

1

ALLIED HEALTH term post application form – 2012