CJDSGN Memorial Award Application Form 2024

CJDSGN Memorial Award Application Form 2024
Applicant
Name

First NameLast Name
Position or Role
Name of Institution
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Institution/s and Investigator/s
Name of Institution/s
Name of Head of Department (HOD)

First NameLast Name
Name of Principal Investigator/s
PhD Student

YesNo
Date PhD commenced:

DayMonthYear
Date
Ph.D. students should also include a statement to explain why their supervisor is not funding the project and how they will manage their time relative to their Ph.D. studies.

Project Title

0/150
Synopsis

0/750
Investigator/s Track Record

0/1000
Project Description

0/2000
Budget

Briefly explain the proposed expenditure.0/750
Funding Period*

12 months24 months60 months
Please note the following:
- Payments will be made annually according to the budget amount for each 12 month period.
- A budget must be provided at the end of each 12 month period detailing budget requirements for the next 12 months.
- On approval of each 12 month budget, an acceptance form must be submitted.
- A variation can be applied for if further funding is required in any of the 12 month periods.
- Any surplus funding for any of the 12 month periods must be deducted from the budget of the following year.
- A further grant for an additional period will be considered at the end of the initial funding period.
Applicant Signature

Clear
Applicant Name

First NameLast Name
HOD Signature

Clear
HOD Name

First NameLast Name
Should be Empty: