James Gear International Fellowship

Name

First NameLast NameTitle

Race

Gender

Institution

Work Address

Full Postal Address

Contact Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

Confirmation Emaila valid email

Institution Name

For Relevant Grant Cheque

Banking Details Of Relevant Institution

Current Qualifications

List your qualifications

Present Professional Status

Tabular

Rows	Name Of Employer / Institution	Capacity And Type Of Work	Period
1
2
3
4
5
6
7
8
9
10

Title Of Project

Place Where Project Is To Be Undertaken

Duration Of Project

Is This Your First Application To The PRF?

Have You Applied For The Same Period To Any Other Organisations For Grants To Finance Other Projects?

Please Supply Relevant Details Below For Other Projects

Rows	Name Of Organisation	Amount Requested	Request Granted?	If Yes, Provide Details
1
2
3
4
5
6
7
8
9
10

Have You Applied For The Same Period To Any Other Organisations For Grants To Finance The Proposed Project?

Please Supply Relevant Details Below For The Proposed Project

Rows	Name Of Organisation	Amount Requested	Request Granted?	If Yes, Provide Details
1
2
3
4
5
6
7
8
9
10

Brief Review Of Published Literature (Max 20 References)

As a general rule, citations older than 10 years should not be used unless they are absolutely necessary in making the case for the proposed study or, if they are seminal works that should not be omitted.

Project Background And Rationale

Specific Objectives

Research Plan And Methodology

Timelines

Apart from your university or institution, please supply details of any other institutions involved with the provision of facilities (including institutions providing clinical material) necessary for this research project

Rows	Name Of Institution	Facilities Required
1
2
3
4
5
6
7
8
9
10

Budget Details (Attach Your Flight Quote At The Bottom Of This Application)

Rows	Description	Cost (VAT Inclusive)
1
2
3
4
5
6
7
8
9
10

Total Budget

NB: Your application will not be considered unless relevant ethics approval has been accepted.

Choose between Human And Animal for their relevant dropdown fields.

Human

Please Provide Certification (PDF)

Max file size: 600KB

Animal

Please Provide Certification (PDF)

Max file size: 600KB

Letter From Current Mentor In Support For This Application

Max file size: 600KB

Letter From International Mentor In Support For This Application

Max file size: 600KB

Upload CV - Including Publications

Max file size: 600KB

Upload Your Flight Quote

Max file size: 600KB

Grants Signatory Form (Can be downloaded at the top of this webpage)

Max file size: 600KB

Any Other Additional Information You Wish To Present, If Graphs, Please upload the graphs in a PDF doc as an annex

Max file size: 600KB

Brief Description of additional Data uploaded

Please provide a brief description of the additional data presented

General Information

Relevant Work Experience To Date

Title Of Project

General Grant Information

Brief Review Of Published Literature

Scope Of The Project For Which A Grant Is Requested (Proosed Research Program And Plan Of Approach)

Facilities

Budget Details

Ethics Committee Certificate

Checklist: Please Complete / Attach