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Hocking Fellowship Application Form

Applications are now open for the 2018 Hocking Fellowship. Please fill in this form and submit your application by 17:00 AEST, Friday June 15, 2018.

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Title*

Please enter your title

First Name*

Please enter your first name

Last Name*

Please enter your last name

Address 1*

Please enter your address

Address 2

Please enter your address if more fields are required

City/Suburb*

Please enter your city or suburb

State*

Please select your state

Country*

Please select your country.

Phone*

Please enter your phone number

Mobile*

Please enter you mobile number

Email*

Please let us know your email address.

About you

About You*

Please enter details about you

Characters remaining: 600

Project Title*

Please enter your project title

Project Aim*

Please enter your project's aims

Characters remaining: 300

About your project

Project Description*

Please enter your project description

Characters remaining: 3000

Why is your project needed?*

Please enter your project benefits

Characters remaining: 500

How will you partner with people affected by complex mental illness in conducting your project?*

Please enter your project benefits

Characters remaining: 1000

How will this involvement benefit those individuals?*

Please enter your project benefits

Characters remaining: 500

How will this project benefit Australians affected by complex mental illness?*

Please enter your project benefits

Characters remaining: 500

How will the results of this project be disseminated?*

Please enter your answer to how the project results will be disseminated

Characters remaining: 500

Who do you hope to reach through these different forms of dissemination?*

Please enter your answer to how the project results will be disseminated

Characters remaining: 500

Workplan and Budget

Please download and complete this work plan and budget spreadsheet with your key activities and timeframes. If you are successful, you will be asked to report on these activities at the end of each quarter.

Workplan and Budget*

Invalid Input

Please upload your Excel spreadsheet for your proposed workplan and budget (up to 2Mb).

Supporting Documentation

Please upload a copy of your CV in .doc or .pdf format

Supporting Documentation*

Please upload your budget document

Please upload a Word, Excel or PDF document with details of your supporting documentation (up to 2Mb).

Referee 1

Please provide contact details for two referees who are familiar with your proposal, and have agreed to be contacted by SANE.

Title*

Please enter your first referee's title

First name*

Please enter your first referee's first name

Last name*

Please enter your first referee's last name

Address*

Please enter your first referee's address

Email*

Please enter your first referee's email address

Phone/Mobile*

Please enter your first referee's phone number

Your relationship to this person*

Please enter your relationship to this person:

Referee 2

Title*

Please enter your second referee's title

First name*

Please enter your second referee's first name

Last name*

Please enter your second referee's last name

Address*

Please enter your second referee's address

Email*

Please enter your second referee's email address

Phone/Mobile*

Please enter your second referee's phone number

Your relationship to this person*

Please enter your relationship to this person:

Declaration

Declaration*

I declare that all information in this application is true and correct, and that I am an Australian citizen or permanent resident. Please check the declaration box

I understand that:

applications must be submitted by 5pm Friday 15 June 2018
closing date is final and late applications will not be accepted
the decision of SANE is final.

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Last updated: 11 May 2018