David Burt Top-up Scholarship Application Form

Student Details

Name: *

Gender

-- Please Select --MaleFemaleOtherPrefer not to disclose

Email: *

Phone Number:

Student ID: *

Department/School and Faculty: *

Commencement Date: *

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Expected end date: *

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Current Scholarship: *

Are you a current member of the Graeme Clark Institute? *

• Yes
• No

Is your research related to human senses? *

• Yes
• No - you are ineligible for this scheme

Are your supervisors from both FEIT and MDHS or external industry partners/clinical hospitals? *

Supervisors being researchers from both faculties; or main supervisor from one of the two above and co-supervisor from external industry partners/clinical hospitals

• Yes
• No - you are ineligible to apply for this scheme

Acknowledgement: *

By applying for the Graeme Clark Institute David Burt Top up scholarship, I agree to be an Institute member and acknowledge the Institute affiliation on my research outputs if successful and give the Institute permission to post my research project highlights on their website or other communication platforms; and provide an annual report.

• Yes

Documents

Project description * Noting the intended impact of the interdisciplinary and innovative research (related to human senses) addressing the scheme's assessment criteria (refer to guidelines); and the co-supervision percentage as well as position and workplace of each supervisor (max 1 page)

Short CV * A two-page CV, showing academic record, research achievements etc

Pitch video (3 minute) * Summarising 1) Research project goals and significance 2) How the Graeme Clark Institute support can enhance your project outcomes 3) How the applicant intends to contribute as a Student Ambassador to the Graeme Clark Institute community. Please upload your video to YouTube or a file-sharing service such as DropBox or OneDrive, and then submit the link. Please ensure any video links have sharing permissions enabled so that anyone with the URL can access/view the file. This video will be viewed exclusively by the review panel and will remain confidential.