AMSI Optimise 2019 - Grant Application Form

Please ensure you have read all of the details and requirements for receiving CHOOSEMATHS support available at

http://research.amsi.org.au/choose-maths-grants/

This form is for CHOOSEMATHS grant applications only. To apply for workshop travel funding visit

https://optimise.amsi.org.au/travel-grants/

AMSI CHOOSEMATHS 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

First Name

Last Name

Email Address

Please use the same email address as you supplied on your registration form

Mobile Number

Organisation

Other Organisation

Gender

Please ensure you have read all of the details and requirements for receiving CHOOSEMATHS support available at

http://research.amsi.org.au/choose-maths-grants/

This form is for CHOOSEMATHS 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?

Organisation	Amount	Status
	$

Do you need to travel with your family (partner and/or child/ren) to attend this event?

YesNo

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 AccommodationCaring Responsibilities

Travel

Origin

How many people are travelling?

Amount Requested

$

Accommodation

Details	Amount Requested
	$

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 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 CHOOSEMATHS Grant Application to assist funding your attendance at AMSI Optimise 2019.

Have you completed the AMSI Optimise registration form, and paid the registration fee?