This Section Is to Be Completed by the Newsupervisor

Higher Degree by Research Supervisor AffiliateForm

Applicants who hold a current appointment with the University of Sydney please refer to Apply to be a Supervisor pageandfill in "Become a Supervisor of HDR Candidates"form.

TheinformationrequestedonthisformwillbeusedtocreateanewaffiliaterecordintheUniversity'sHRinformationsystem. For further information refer to About Supervisionpage, theAffiliates Policy and theUniversity PrivacyPolicy.

THIS SECTION IS TO BE COMPLETED BY THE NEWSUPERVISOR

Supervisor details

Title / Surname / Given names

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Work phone / Mobile phone / Email / Gender / Date of birth
Address / Suburb / State / Postcode

Primary institution (institutional affiliation)

Name of Institution / Faculty / School

Previous association with the University of Sydney

IhavepreviouslybeenassociatedwiththeUniversity(forexample,asacasual/tenuredstaff, or worked under a differentname) / Yes / No
If yes, provide following details to help us retrieve yourrecords:
Staff ID / Employment details or alternatename

Supervisor experience

I have previously supervised Higher Degree by Researchcandidates / Yes / No
If yes, provide the following details for two most recentcandidates:
Student name / Institution / Degree / Year of award

Supporting documents

Proofofidentity(passportorotherdocumentsasper100pointcheck).Originaldocumentstobesightedorcertifiedcopiesprovided
Evidence of current visa or proof of Australian citizenship, if you intend to perform work inAustralia
CV (the application will not be considered withoutCV)
Is the position child-related work as per Working with ChildrenPolicy?Yes No
If yes, please provide:-
-Statutory declaration – working with children or
-Working with children check number / application number

Supervisor experience

Iamanactiveresearcherasdefinedbythestandardssetbythefacultyapprovingthisapplication.

IhaveattachedmyCVdemonstratingmyresearchactivity,qualificationsandotherprofessionalorresearchexperience.

IamfamiliarwithandagreetoabidebytheUniversityofSydneyrules,policiesandproceduresastheypertaintohigherdegreesbyresearch.

Name / Signature / Date

Please email the completed form to your Faculty HDR Administrative staff. The contact names are available onSupervisorRegister page under "further information"links.

Privacy

The information you provide on this form is required to assess and approve your suitability as a Supervisor of a Higher Degree Research Candidate at the University of Sydney. Failure to supply the required information may result in your application not being considered. The information will not be used for any other purpose or disclosed outside the University except in accordance with the University’s Privacy Policy. It will be retained as required by the NSW State Records Act. You have the right to access and correct the information about you, please contact the Graduate Studies Office for further information.

THIS SECTION IS TO BE COMPLETED BY FACULTY HDR ADMINISTRATIVESTAFF

Affiliationdetails

Start date / End date
Note: maximum term is 4years.
Faculty / School / Discipline

Facultyapproval(mustbeapprovedbytheDeanorAssociateDeanoftherelevantfaculty)

IapprovefortheapplicanttobemadeaHigherDegreebyResearchSupervisorAffiliateandaddedtotheSupervisorRegisterinaccordancewiththedetailson thisform.

Research Supervisor /
Auxiliary supervisoronly / Doctorate andMaster's /
Master’s only
Register this applicantas: / Supervising level:
Name / Signature / Date

Pleaseemailthecompletedformandallattachmentsto:

TheGSOwillupdatethesupervisorregisterandliaisewiththeHRServiceCentretocompletetheprocess.

Page 1 of 2Last updated:11 October 2018