Application Form - lowitja.org.au · Web viewThe Lowitja Institute is Australia’s national...
Transcript of Application Form - lowitja.org.au · Web viewThe Lowitja Institute is Australia’s national...
Starlight Foundation ScholarshipApplication Form
Application FormSeeking Applications
Closing date is Friday 15 March 2018 (midnight AEDT)The Lowitja Institute is Australia’s national institute for Aboriginal and Torres Strait Islander health research, named in honour of its Patron, Dr Lowitja O’Donoghue AC CBE DSG. The Institute was established in 2010, emerging from a 14-year history of Cooperative Research Centres funded by the Australian Government CRC Program. The Institute operates on key principles of Aboriginal and Torres Strait Islander leadership, a broader understanding of health that incorporates wellbeing, and the need for the work to have a clear and positive impact.
Established in 1988, the Starlight Children’s Foundation delivers programs across Australia and New Zealand in partnership with health professionals, to support children, adolescents and their families who are living with a serious illness, disability or health condition. Starlight's Healthier Futures Initiative is a collaborative program supporting better health outcomes for children in Indigenous communities.
About the Award The Lowitja Institute and Starlight Children’s Foundation are excited to offer a post-graduate scholarship focusing on the health and resilience of Aboriginal and Torres Strait Islander children and young people, with opportunities to explore concepts such as the use of humour, wellbeing, laughter, play and imagination, amongst the possible areas of interest.
Eligibility Criteria An Australian citizen Aboriginal and/or Torres Strait Islander Eligible to study at a postgraduate level (PhD, or Masters (by research). Enrolled or will be enrolled as a postgraduate student (full-time or part-time) at an
Australian University Research focus on the health and resilience of Aboriginal and Torres Strait Islander
children and young people with possible areas of interest such as humour, wellbeing, laughter, play and imagination.
Submitting applications The application form and all supporting document must be uploaded and submitted via the
Lowitja Institute website at www.lowitja.org.au/starlight-scholarship All supporting documents must be combined into a single MS Word or PDF file (i.e. only
one attachment is allowed) An application must be submitted before midnight of the nominated date. All required
supporting documentation are to be submitted with the completed application form. Applicants will receive an auto-generated email acknowledging receipt of their application.
Incomplete or late applications will not be considered.
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Starlight Foundation ScholarshipApplication Form
If an email is not received within 24 hours, the applicant must contact Ms Emma Somerville on (t: 03 8341 5517 or e: [email protected]).
It is an applicant’s responsibility to ensure their application has been received. The Lowitja Institute does not accept any liability if an application is not received by the due date.
Contact details
Title
First name
Last name
Phone
Mobile
Postal address
Are you of Aboriginal or Torres Strait Islander origin?
Aboriginal Torres Strait Islander Aboriginal and Torres Strait Islander NoProof of origin may be required if your application is successful
Enrolment details Evidence of your enrolment will be required if offered a scholarship
Name of enrolling university
Campus location
Faculty/School
Title of enrolling post graduate program
Course commencement date
Proposed course completion date
Administering institution
Insert name of scholarship funds administering institution if different from university of enrolment.
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Supervisor details
Do you require support to find supervisors?
☐ Yes – if yes, move to ‘Other Financial Support’☐ No
Primary supervisorName of primary supervisor
Institution & campus
Phone
Mobile
Secondary supervisorName of secondary supervisor
Institution & campus
Phone
Mobile
Other financial supportProvide the details of any other financial support you have applied for or have received
☐ Yes I have applied for or have received other financial support
☐ No I have not applied for or have received other financial support
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Starlight Foundation ScholarshipApplication Form
Research activity detailsLowitja Institute Research PrinciplesThe Lowitja Institute is committed to the highest standards of integrity in research practice. As the national institute for Aboriginal and Torres Strait Islander health research, and being an Aboriginal and Torres Strait Islander organisation, it is incumbent upon us to demonstrate what integrity in research practice, and ethics, means for Aboriginal and Torres Strait Islander health research. The five principles that underpin the Lowitja Institute’s approach to ethical research are:
1. Beneficence – to act for the benefit of Aboriginal and Torres Strait Islander people in the conduct of our research
2. Leadership by Aboriginal and Torres Strait Islander people3. Engagement of research end users (Aboriginal and Torres Strait Islander organisations
and communities, policy makers, other potential research users) 4. Development of the Aboriginal and Torres Strait Islander research workforce and5. Measurement of impact in improving Aboriginal and Torres Strait Islander people’s
health.This means that Aboriginal and Torres Strait Islander people must be meaningfully involved in the research and requires people to work together in genuine, transparent and mutually respectful partnerships. A Lowitja Scholarship recipient’s post-graduate research will be required to demonstrate sound ethics practice. This process is to be informed by:
National Statement on Ethical Conduct in Human Research 2007 Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander
Health Research and the Guidelines for Ethical Research in Indigenous Studies Keeping Research on Track: A guide for Aboriginal and Torres Strait Islander peoples
about health research ethics
Resources to support ethical practice can be found at the Lowitja Institute Ethics Hub at: www.lowitja.org.au/ethics
Research activity title (maximum 20 words)
INSERT YOUR TEXT HERE
Research activity or question (maximum 100 words)
Describe your research question and research objectives
INSERT YOUR TEXT HERE
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Research significance Provide a detailed outline of the significance of the proposed research and why it’s important in the broader context, the benefits and its overall impact. How does the research proposal extend prior knowledge or respond to emerging or future health trends?INSERT YOUR TEXT HERE
Proposed research design and methodProvide a detailed outline of the proposed research this should include: development of proposed research concept; methodology (target audience, sample size, data collection method and tools, data analysis and interpretation), and a project planINSERT YOUR TEXT HERE
Knowledge Translation PlanThe Lowitja Institute considers it is vitally important that our investment in research results in lasting positive impact on the health and wellbeing of Aboriginal and Torres Strait Islander people. ‘knowledge exchange’ refers to the process of mutual two-way learning between the research and those engaged in the research project. ‘research translation’ refers to the identification and facilitation of policy and/or practice outcomes based on the evidence generated through research. Our knowledge exchange approach is outlined on the Lowitja Institute website at https://www.lowitja.org.au/knowledge-exchange
Complete the following table – add more rows as required
Knowledge Translation PlanNominated Target
Audience Goal of KT Activity Proposed KT ActivityWho needs to hear about the key outcomes from your project? Who needs to use this knowledge?
What is your goal in mobilising the outcomes from your project to this group – do you want to inform them about your project’s findings; raise their awareness about the topic or change their behaviour?
How will you achieve the proposed goal? What activity will you do?
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Ethics approvalWill your research require ethics approval?☐ No – my research will not require any ethical approval☐ Yes – my research will require any ethical approvalIf Yes, provide details of the ethics committee/s you will seek approval from? (Maximum 300 words)INSERT YOUR TEXT HERE
Lowitja Institute Research Principles
Describe how your project demonstrates the following Lowitja Institute Principles (Maximum 300 words)
1. Beneficence – to act for the benefit of Aboriginal and Torres Strait Islander people in the conduct of our researchINSERT YOUR TEXT HERE
2. Leadership by Aboriginal and Torres Strait Islander peopleINSERT YOUR TEXT HERE
3. Engagement and involvement of research end users (Aboriginal and Torres Strait Islander organisations and communities, policy makers, other potential research users) INSERT YOUR TEXT HERE
4. Development of the Aboriginal and Torres Strait Islander research workforceINSERT YOUR TEXT HERE
5. Measurement of impact in improving Aboriginal and Torres Strait Islander people’s healthINSERT YOUR TEXT HERE
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Starlight Foundation ScholarshipApplication Form
Intellectual propertyThe Lowitja Institute recognises the fundamental importance of identifying and classifying intellectual property (IP) developed from research activities funded by the Lowitja Institute, as well as protecting background IP provided to research activities by Aboriginal and Torres Strait Islander people along with that of other participants in research collaborations. Applicants should be aware that, if they are successful in obtaining funding for their research, IP will be discussed and negotiated to achieve an equitable outcome for all parties as part of the Institute’s general research funding agreement negotiations.
Is there any background IP to be brought to your research? Background IP is IP that was developed before the research commenced and that you will use in your research. Please identify any background IP that you will bring to your research. (Maximum 200 words)
INSERT YOUR TEXT HERE
Supporting academic information
QualificationsAttach official documentation of your recent academic qualification/s – Institution, award, year, etc.
Curriculum VitaeAttach a CV, maximum of 4 A4 pages
Academic Supervisors If you are seeking support to find supervisors – this requirement is not applicable Attach Academic Supervisors Form – you will require a response from each of your
proposed supervisors.
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Applicant’s declaration Please print and sign this declaration. Include your signed declaration in your supporting documents. I declare that the information supplied in this application is true and correct and that the listed supporting documents have been supplied. I have original copies of all submitted documents and I understand that the Lowitja Institute may request sighting the original documents for the purpose of verification. I acknowledge that all documents submitted will become the property of the Lowitja Institute and, as such, will not be returned to me.
Yes / NoI understand that the information collected in this application form will enable the Lowitja Institute to assess my application and, if my application is successful, create a legally binding Scholarship Agreement. I also understand that if I do not complete all relevant sections of this application or fail to supply all supporting documentation my application will not proceed.
Yes / NoI understand that it is a serious offence under the Criminal Code of the Australian Commonwealth to give misleading or false information and I acknowledge that the Lowitja Institute reserves the right to reverse any decision made about my scholarship application funding if it is found that I have provided misleading or false information.
Yes / No
Name
Signature
Date
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