Application: 2018 Fellowship Expression of Interest BioMed City – Application for: Fellowship category Intended Research Group (if relevant) Program/Research Group you propose to work in: Select one of the following: Head of Research Early Career Fellowship (ECF) 2 Years – Primary disease or condition being researched: Mid-Career Fellowship (MCR) 3 Years – Grant Period: 1 July 2018 30 June 2020 (ECR) or 30 June 2021 (MCR) NOTE: – ________________________________________ Applicant details Title: First name: Initial: Last name: Institution Name: School/Centre/Institute: Faculty: Full Postal Address work (including DX#): – Phone Number: E-mail Address: Appointment held, including year of appointment: Current position renewal date: Date of Award of Higher Degree: Number of years’ research experience post PhD: Research Experience: Institution Position title Research activities (short Inclusive dates worked description)
Application: 2018 Fellowship Expression of Interest – BioMed City Application for: Fellowship category Intended Research Group (if relevant) Select one of the following: Early Career Fellowship (ECF) – 2 Years Mid-Career Fellowship (MCR) – 3 Years Program/Research Group you propose to work in: Head of Research Primary disease or condition being researched: NOTE: Grant Period: 1 July 2018 – 30 June 2020 (ECR) or 30 June 2021 (MCR) ________________________________________ Applicant details Title: First name: Initial: Last name: Institution Name: School/Centre/Institute: Faculty: Full Postal Address – work (including DX#): Phone Number: E-mail Address: Appointment held, including year of appointment: Current position renewal date: Date of Award of Higher Degree: Number of years’ research experience post PhD: Research Experience: Institution Position title Research activities (short description) Inclusive dates worked
Application-form-Fellowships.docx