Expression of Interest Submission Form

Closing Wednesday, 08 July 2020, 11:59pm AEST

Welcome

Please remember to refer to the EOI instructions while you are completing your submission. These are available on the UTSCPDRF web page

Your EOI application document can be submitted once only. No further changes are possible after this form is finalised andyour EOI is submitted.

For any questions, please email cpdrf@uts.edu.au.

I acknowledge that if my submission is incomplete at the submission deadline, it will not be forwarded to the nominated host

Faculty for assessment.

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I agree and would like to proceed.

The information collected in this form will be exclusively used to administer the CPDRF application process, in accordancewith the UTS CPDRF Privacy Statement. For any queries, changes to your registration details after submission or if youdecide not to proceed, please email cpdrf@uts.edu.au.

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Applicant Information

Title (e.g. Dr, Ms, Mr):

Given Name(s):

Family Name:

Candidate Name:*

Email Address:

Email Contact:

Important: Please ensure your email address is valid and accessible, as it will be used for all officialcorrespondence. You are advised to configure the spam filter (if any) not to block emails from thedomain uts.edu.au and surveymonkey.com, otherwise you may not receive essential correspondence.

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Phone:

Phone Contact:

Please provide a phone number on which you may be contacted for urgent matters (mobile preferred).Please include the country code, e.g. +61...

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Title (e.g. Dr, A/Prof, Prof):

Given Name(s):

Family Name:

Fellowship Supervisor

At the time you lodge your EOI, your proposed UTS CPD supervisor must have agreed to support your application. Please note: it is

not possible to change supervisors without a valid reason, or to nominate more than one supervisor.

My nominated Fellowship Supervisor at UTS is:

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UTS Faculty (or equivalent)This will be the same Faculty that your nominated UTS supervisor belongs to.

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Please select the Fellowship you are applying for:

It is important you refer to the relevant guidelines before making your selection. Note: You can only applyfor one Fellowship program.

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Chancellor's Postdoctoral Research Fellowship 2021

Chancellor's Postdoctoral Indigenous Research Fellowship 2021

Right to Work:Do you currently have the unrestricted right to work in Australia, covering the full duration of the four yearfixed term contract?

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Yes, I am an Australian or New Zealand citizen

Yes, I am a permanent resident of Australia

I currently hold a temporary Australian visa for the duration of the fellowship

None of the above - candidates are not eligible to apply. Please contact CPDRF@uts.edu.au for further information

Country of Citizenship:

Visa subclass:

Expiry date:

Please provide the following information:

You must have the unrestricted right to work in Australia covering the full four year fixed term contractperiod to be eligible to apply. EOIs will be assessed for this criteria, and candidates who do not meet thiseligibility requirement will not proceed.

Please confirm your PhD award status as of today:*

PhD has been awarded

Awaiting conferral of PhD

Thesis has been submitted - under examination

Thesis will be submitted later this year

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PhD Qualification - Awarded

Date / Time

Date

DD/MM/YYYY

When were you officially awarded your PhD?

For the purpose of this application, this is the date your PhD testamur was issued.The date must be on or before 08 July 2020, otherwise, go back and selected 'PhD not yet awarded'

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Do you wish to request an eligibility exemption?

If your PhD was awarded on or after 1 July 2015, you will not require an exemption - select 'No'.If you select 'Yes', you will be contacted by UTS to make a case for eligibility exemption.

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Yes

No

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Eligibility Exemption

No file chosen

Please upload your completed CPD Career Disruption Eligibility Request

This document can be downloaded from the CPDRF 'How to Apply' page

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PhD Qualification - Prospective

PhD submission date (required for all options - DD/MM/YYYY):

Since you have not yet officially received your PhD degree, please select an option that best describes your circumstances as of the EOI closing date (08 July 2020):

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I plan to submit my PhD thesis later this year.

I have submitted my PhD thesis for examination, and I am currently awaiting the outcome.

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The information requested on this page is required for administrative purposes only and will notbe forwarded to the assessors of your application.

Additional Information

GenderThis information is optional and only required to assist the university in monitoring the UTS ResearchEquity Initiative.

Female

Male

Not specified

Are you applying for the Fellowship on a full-time or part-time basis?*

Full-time

Part-time

Undecided

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Please tell us where you first saw an advertisement or heard about the UTS Chancellor'sPostdoctoral Research Fellowships:

Referral from PhD or postdoctoral supervisor

Referral from other colleagues

Faculty newsletter

UTS website

LinkedIn

SEEK

Research Career

Jobs.ac.uk

PostdocJobs

Research Gate

The Chronicle

Scholarship Positions

Sciencemag.org

Other (please specify)

UTS Staff ID, if known:

Are you currently, or have you previously been, employed by the University of Technology Sydney?

Yes

No

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Project Title & Summary

Project Title

Please provide a short, descriptive title of your proposed project in up to 100 characters (approx. 12 words). Avoid discipline-specific

terms and abbreviations.

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Project SummaryPlease provide a summary outlining the proposed project (maximum 700 characters or approx 100 words).

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Proposed Fellowship Project

No file chosen

Proposed Fellowship Project

Upload a document of no more than two A4 pages and in the format prescribed.

Use this section to promote your proposed Fellowship project to the Faculty Selection Committee. Refer tothe guidelines and instructions for requirements.

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Choose File Choose File

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Selection of Supervisor and UTS

No file chosen

Selection of Supervisor and UTS

Upload a document of no more than one A4 page and in the format prescribed. Selection of supervisor -Refer to the guidelines and instructions for requirements.

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Choose File Choose File

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Curriculum Vitae

No file chosen

Curriculum Vitae

Please upload your document (1 page maximum, 12pt font only). Curriculum Vitae - Refer to theguidelines and instructions for other requirements.

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Research record relative to opportunity

No file chosen

Research Record Relative to Opportunity

Upload a document of no more than one A4 page and in the format prescribed. Research record relativeto opportunity - Refer to guidelines and instructions for additional requirements, including the sections thatshould be addressed.

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Choose File Choose File

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Research Outputs

# ofpublications

# of citations(excl. self)

# ofpublicationsas leadingauthor

# ofpublicationssince PhDaward date

Scholarly Books

# of publications

# of citations (excl. self)

# of publications asleading author

# of publications sincePhD award date

Scholarly Book Chapters

# of publications

# of citations (excl. self)

# of publications asleading author

# of publications sincePhD award date

Refereed Journal Articles

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# of publications

# of citations (excludingself-citations)

# of publications asleading author

# of publications sincePhD award date

Refereed Conference Papers

Source of publication count - select one only*

Scopus

Web of Science

Microsoft Academic - not permitted for Candidates in FEIT, FoH, GSH and SCI

Google Scholar - not permitted for Candidates in FEIT, FoH, GSH and SCI

Not applicable - No research outputs have been recorded

Date / Time

Date

DD/MM/YYYY

Date of bibliometrics data retrieval

Additional Commentary2000 character limit (approx 300 words)

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Research Outputs Cont.

If you do not have anyoutputs, please just addN/A to this field

'Top 10' Career-best Research Outputs

List up to ten of your publications which you consider the best of your career.

Each output summary can be up to 200 characters long.

1

Output Summary

2

Output Summary

3

Output Summary

4

Output Summary

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5

Output Summary

6

Output Summary

7

Output Summary

8

Output Summary

9

Output Summary

10

Output Summary

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Confirmation

1 . All information provided in this online form and in the attached documents is complete and correct. The EOI cannot be updated oramended once it has been submitted.

2. Upon request, I will provide supporting documents to substantiate my responses.

3. My nominated Fellowship Supervisor has agreed to support my application without reservation, and I agree that related outcomecorrespondence will be shared with them and the host faculty or equivalent.

By finalising my EOI submission, I certify the above:*

Yes

No

Any short, administrative notes in relation to your application may be provided here (will not be forwarded to the Selection

Committee). If you have a question that requires a response, please email cpdrf@uts.edu.au.

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Submission

Thank you for completing the online EOI submission for the UTS 2021 Chancellors Postdoctoral Research Fellowships! You will be notified once the EOI has been received.

The announcement of EOI outcomes is tentatively scheduled for 17 June 2020.

Please click 'Submit' below to process your EOI

If you decide to withdraw your application for any reason, we would appreciate if you could please promptly notify us atcpdrf@uts.edu.au

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