Application Form2019 Post-Doctoral Fellowship

The Suicide Prevention Research Fundis proudly supported by

Key stepsFINAL – v1 6 September 2019

Application Form - 2019 Post-Doctoral Fellowship

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1. Review the Application guidelines2. Review the Application checklist3. Complete Application form in your preferred format4. Cross reference the Application guidelines and checklist to ensure you have addressed all criteria5. Submit the Application and supporting documentation to sprf@suicidepreventionaust.org by

11:59pm (AEST) on Monday 14 October 2019

GuidelinesPlease review the application guidelines which can be found at <insert link to guidelines>

Key dates

Application periodOpens

9 September 2019Closes

14 October 2019

Formatting requirements Applicants must:

1. Address all questions below using this template 2. Take note of character limits for each section – character limits are exclusive of spaces3. Complete forms in Calibri 11pt4. Use the file naming conventions below:

a. Application Application – First name Surname – Administering Institution name

b. Resumes Resume - First name Surname

c. Letter of Support Letter of Support - Administering Institution name

d. Letter of Involvement (if applicable) Letter of Involvement - Partner Organisation name

5. Supply supporting documents in separate files in Word or PDF format

To assist with completing the application please refer to the Post-Doctoral Fellowship guidelines on the Suicide Prevention Australia website.

EnquiriesIf you have enquiries regarding the research grant program please contact Suicide Prevention Australia on

+61 (2) 9262 1130 or email sprf@suicidepreventionaust.org

1. The Applicant

Application Form - 2019 Post-Doctoral Fellowship

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Applicant details

Position:

Title:

First name:

Last name:

Primary contact number:

Email address:

Note: Applicant’s resume required, see template Applicant Resume – 2019 Post-Doctoral Fellowship

PhD details

Thesis title:

Research category:

Institution name:

PhD Supervisor details

Position:

Title:

First name:

Last name:

Primary contact number:

Email address:

Are thesis results known? Yes - if yes please supply at time of application No

If no, when can they be expected?

2. The Administering Institution

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Administering Institution details

Institution name:

Institution address:

Note: A Letter of Support from the Administering Institution must be provided at time of application

Research Administration Officer (RAO) details

Position:

Title:

First name:

Last name:

Primary contact number:

Email address:

Is the application being submitted by the RAO on behalf of the Applicant?

Yes No

Academic Supervisor details

Position:

Title:

First name:

Last name:

Primary contact number:

Email address:

Note: Academic Supervisor’s resume required, see template Academic Supervisor Resume – 2019 Post-Doctoral Fellowship

3. The Partner Organisation (if applicable)

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Partner Organisation details

Organisation name:

Organisation address:

Note: A Letter of Involvement must be provided if the applicant will be partnering with a Partner Organisation for the duration of the Post-Doctoral Fellowship

Partner Organisation contact details

Position:

Title:

First name:

Last name:

Primary contact number:

Email address:

Partner Organisation Supervisor details

Position:

Title:

First name:

Last name:

Primary contact number:

Email address:

4. Area(s) of Research

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Please indicate primary (required) and secondary (if applicable) areas of research focus by placing 1 and 2 respectively within the checkboxes.

Universal Selective

Means Access Reduction Education and Community Engagement

Media and Communications Resilience and Wellbeing

Public Awareness Training

Indicated Recovery

Crisis Intervention Postvention for Communities

Crisis Aftercare Bereavement Support

Personal Support Lived Experience and Peer Support

Clinical Care

Infrastructure

Information and Referral Services

Data surveillance, screening and

reporting

Oversight and Coordination

5. Responses to Selection Criteria

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The Suicide Prevention Research FundDescribe how the proposed research supports the priorities of the Suicide Prevention Research Fund (1000 character limit)

The ResearchResearch title (200 character limit)

Brief synopsis including description, rationale, key objectives and outcomes (3000 character limit)

Describe the scientific merit of the research design, methods and measures (1000 character limit)

Describe how the research can contribute to practical interventions in suicide prevention

(1000 character limit)

Describe how the research activity will translate into knowledge to the broader suicide prevention community (1000 character limit)

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Describe how the research activity will be informed by or in collaboration with people with lived experience (1000 character limit)

The ResearcherDescribe your research track record of achievement relative to career opportunity (3000 character limit)

Demonstrate your potential for further career development in health, social or medical research (1000 character limit)

Describe your strategy for career development as a researcher (1000 character limit)

The Research Environment

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Describe how the Administering Institution will provide a supportive research environment including existing relevant research program and infrastructure (1000 character limit)

Detail how adequate academic, senior-level supervision of the researcher and associated research will be provided (1000 character limit)

6. Ethics Approval

Is ethics approval required for proposed research activities?

Yes No

If yes, do you have ethics approval at this time?

Yes No

7. Referee details

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Written references from your most recent employers or academic supervisors will need to be provided at time of application. Please provide contact details below.

Referee 1

Position:

Title:

First name:

Last name:

Primary contact number:

Email address:

Referee 2

Position:

Title:

First name:

Last name:

Primary contact number:

Email address:

8. Proposed Budget

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Item Purpose Amount ($)

Applicant

Salary

Year 1 $

Year 2 $

Cost of publishing in academic journals

$

$

$

Other

$

$

$

$

Administering Institution

In-kind contributions

$

$

$

$

Cash contributions

$

$

$

$

Partner Organisation (if applicable)

In-kind contributions

$

$

$

Cash contributions

$

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Item Purpose Amount ($)

$

$

Sum total Suicide Prevention Research Funds requested $

Sum total Administering Institution contribution $

Sum total Partner Organisation contribution $

Grand total $