The Matthew Scriver

PICU Nurses Scholarship

2008 APPLICATION FORMAT

The following information is required, in the listed order.

  1. Full name:

Family name first, followed by other names

  1. Contact details:

Postal address for correspondence

Telephone number during working hours (not mandatory)

Email address

  1. Personal CV

The CV should include:

3.1Education and qualifications

3.2Employment record

  1. Outline of proposed research project:

This should include:

4.1Title of the proposed research project

4.2Name CYWHS Departmentwhere the work will be undertaken

4.3A brief description of the research project in lay terms (300 words or less)

4.4A brief description of the research project (6 pages or less), including

•research objectives

•recruitment and consent

•research methods

•data analysis and interpretation techniques

•significance of the study for health care in a PICU setting

4.5copy of research ethics approval (if obtained)

4.6name of the proposed supervisor(s)

4.7proposed commencement date

4.8a letter from the Head of the Department/Institution concerned, supporting the application, and confirming that the Department/Institution can provide appropriate supervision and facilities for the proposed research project, should the application be successful.

  1. Outline of where and in what format the applicant is aiming to publish and/or present the research findings
  1. Referees

The applicant must request reports from two referees (names and addresses to be given in the application) on the applicant’s academic and personal abilities to undertake the proposed research project. These reports are to be forwarded to the Matthew Scriver PICU Nurses Scholarship, c/- Research Secretariat, 72 King William Rd, North Adelaide 5006) by5 pm Friday 2nd November 2007.

  1. Any other informationThe applicant should provide any other information which may help in the assessment of the application.
  1. Signature and date

Four hard copies of the application are required, and should be sent to:-

The Matthew Scriver PICU Nurses Scholarship

c/- Research Secretariat,

Children Youth and Women’s Health Service

72 King William Road,

NORTH ADELAIDE. SA 5006.

no later than 5 pm Friday2ndNovember 2007

Late applications will not be accepted.