HSANZ Clinical Fellowships Application

1. About the applicant
Name*

First NameLast Name
Residential Address

Street Address

Street Address Line 2

CityState

Post Code
Mobile Phone Number*
Email*
example@example.com
ALLG Full MemberALLG Associate MemberALLG Registrar / Trainee Member
HSANZ Ordinary MemberHSANZ Trainee Member
Please upload your CV (maximum 3 pages)*

Ensure your CV includes demographics; academic background; honours and scholarships; publications; presentations; research funding; contribution to haematology including leadership / HSANZ / teaching / review / community engagement.
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Please upload evidence of your accredited trainee in haematology status or your qualified haematology status

For example- official communications from RACP or RCPA confirming your status
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2. Host Institution Information & Supervisors
Please provide the department and institution where you plan to undertake your Fellowship*
Proposed Supervisor (1) - please enter the details below*
Upload a CV for Supervisor (1)*

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Upload a letter from Fellowship Supervisor (1) outlining supervision arrangements and viability of proposed project in the 12 or 24 month period. Institutional commitment is required to provide protected research time (equivalent to approximately 50% FTE where applicable) and relevant resources and equipment to undertake the proposed research. *

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Proposed Co-Supervisor (2) - please enter the details below*
Upload a CV for Co-Supervisor (2)*

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3. Referee Details

Your referee must be a recent manager or training supervisor
Please provide the details below for your referee*
Please upload a written reference from your referee (1 page maximum)*

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4. Your Fellowship project
Title of your Research project*
Statement of how proposed Fellowship project directly relates to HSANZ's aims and objectives and the promotion of Haematology practice*
Statement of how your Fellowship project is aligned with ALLG's Scientific Research Strategy*
Please upload your research proposal (maximum 5 pages)*

Please follow the research proposal template provided here: https://hsanz.org.au/resources/Documents/ScholarshipsFellowships/FSHIP_Research_Proposal_Template_2026.pdf
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Please upload a detailed statement outlining how you propose to use the funds, including differentiation between funding allocation to stipend and / or project consumables. Include details of any additional funding already secured for the project (maximum 1 page)*

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Award Selection