AMSI Optimise 2019 - Grant Application Form
Please ensure you have read all of the details and requirements for receiving CHOOSE
MATHS
support available at
http://research.amsi.org.au/choose-maths-grants/
This form is for CHOOSE
MATHS
grant applications only. To apply for workshop travel funding visit
https://optimise.amsi.org.au/travel-grants/
AMSI
CHOOSE
MATHS
Grants are designed to provide full or partial support for female Australian mathematical sciences students and early career researchers at AMSI Member organisations to attend and participate in the AMSI Flagship programs.
This form should be completed only after you have fully completed and submitted the AMSI Optimise registration form at
https://optimise.amsi.org.au/register/
and processed your registration fee payment.
If you have any technical issues with the form or receive any errors please contact
angela.coughlin@amsi.org.au
.
Title
Please select...
Adjunct Associate Professor
Adjunct ClinAssProfessor
Adjunct Professor
Assistant Commissioner
Assistant Professor
Associate Professor
Councillor
Dame
Dr
Emeritus Professor
Inspector
Lady
Miss
Mr
Mrs
Ms
Professor
Reverend
Senator
Senator the Hon
Senior Constable
Senior Sergeant
Sergeant
Sir
Superintendent
The Hon
The Hon. Dr
Winthrop Professor
First Name
Last Name
Email Address
Please use the same email address as you supplied on your registration form
Mobile Number
Organisation
Please select...
Australian Bureau of Statistics
Australian Defence Force Academy
Australian Mathematics Trust
Bureau of Meteorology
Charles Sturt University
CSIRO Data61
Curtin University of Technology
Deakin University
Defence Science and Technology Group
Federation University Australia
Flinders University
James Cook University
La Trobe University
Macquarie University
Monash University
Murdoch University
Queensland University of Technology
RMIT University
Swinburne University of Technology
The Australian National University
The University of Adelaide
The University of Melbourne
The University of Newcastle
The University of New England
The University of New South Wales
The University of Queensland
The University of Sydney
The University of Sydney
The University of Western Australia
University of South Australia
University of Southern Queensland
University of Tasmania
University of Technology Sydney
University of Wollongong
Victoria University
Western Sydney University
Other
Other Organisation
Gender
Please select...
Male
Female
Other
Prefer not to disclose
Please ensure you have read all of the details and requirements for receiving CHOOSE
MATHS
support available at
http://research.amsi.org.au/choose-maths-grants/
This form is for CHOOSE
MATHS
grant applications only. To apply for workshop travel funding visit
https://optimise.amsi.org.au/travel-grants/
Are you applying for full funding or partial funding?
Full Funding
Partial Funding (50%)
Have you already applied for or been allocated any other financial support to attend AMSI Optimise 2019?
Please select...
Yes
No
Organisation
Amount
Status
$
Please select...
Applied
Confirmed
Received
Do you need to travel with your family (partner and/or child/ren) to attend this event?
Yes
No
In 200 words or less, please provide details about your dependent/s, and tell us why you need to travel with your family to attend AMSI Optimise 2019.
What type of funding would you like to apply for? (tick all that apply)
Travel
Accommodation
Caring Responsibilities
Travel
Origin
Please select...
ACT
NSW
NT
QLD
SA
TAS
VIC
WA - regional (travel funding is not available to Perth attendees)
How many people are travelling?
Please select...
1
2
3
4
5
6
7 or more
Amount Requested
$
Accommodation
Details
Amount Requested
Please select...
Off-Campus Accommodation
$
Please provide details about suitable accommodation option/s
Details on accommodation options available near the conference venue are listed at
https://optimise.amsi.org.au/getting-here/
Caring Responsibilities
Details
Amount Requested
Please select...
Childcare
Temporary Respite
Other
$
Please provide details about suitable caring responsibility option/s
In 200 words or less, please tell us why you are attending and want to participate in this program.
In 200 words or less, please tell us how participating in the program will benefit your skills development and career.
In 200 words or less, please provide any other information that you think we should know that is relevant to your application.
Upload your CV
Attach your CV to outline your academic, professional and/or research history to support your Grant Application to assist funding your attendance at AMSI Optimise 2019.
Upload a Letter of Support
Attach a letter (or email) of support (PDF files only) from your current supervisor, honours coordinator or head of department to support your CHOOSE
MATHS
Grant Application to assist funding your attendance at AMSI Optimise 2019.
Have you completed the AMSI Optimise registration form, and paid the registration fee?
Please select...
Yes
No
Contact Information