Information in support of your application Please provide a brief explanation of why you are applying for this Fellowship and any relevant experience that may support your application. Please do not exceed 300 words. I confirm that the above particulars are correct Signature: Date: This part of the form should be completed by your PhD Supervisor: I confirm that the above particulars are correct. If the application is successful, I give my permission for the above applicant to suspend their PhD studies for three months. Name (please print): Signature: Date:
Information in support of your application Please provide a brief explanation of why you are applying for this Fellowship and any relevant experience that may support your application. Please do not exceed 300 words. I confirm that the above particulars are correct Signature: Date: This part of the form should be completed by your PhD Supervisor: I confirm that the above particulars are correct. If the application is successful, I give my permission for the above applicant to suspend their PhD studies for three months. Name (please print): Signature: Date: