M Rushforth Bursary Form 2013

APPLICATION FOR M RUSHFORTH BURSARY FOR2016

RULES

Whereas an anonymous donor has offered a sum of $10,000 to promote the studyof ophthalmology;andwhereasthedonorhasrequestedthatthesumbeusedtoprovide assistance to students in the clinical years of the course for the degree of Bachelorof MedicineandBachelorofSurgerywhomaywishlatertospecialiseinophthalmology;and whereasthedonorhasaskedthatthenameofMRushforthbeassociatedwiththeBursary; and whereas the sum has been accepted by the Council of the University which has agreedtothefoundationofaBursaryinthetermsdeclaredintheseRules,itisherebyprovidedas follows:

1The aforesaid sum, together with any accumulation of income from time to timeadded thereto,shallformtheendowmentofaBursarytobecalledtheM.RushforthBursary.

2The Bursary shall be awarded to students in the second last year of the course forthe degree of Bachelor of Medicine and Bachelor ofSurgery.

3Theawardshallbemadetostudentswishingtotakeanophthalmologyelectiveina ophthalmology unit outsideTasmania.

4Applications for the award shall be made at the beginning of the second last year ofthedegreecourse.

5The award shall be made by a committee appointed for this purpose by theAcademicDean of the Faculty of Medicine and Pharmacy [now the Dean of the Faculty ofHealth Science].

6Subject to these Rules, the committee may determine the detailed procedures fortheselection and award of theBursary.

7The Bursary shall be of such value as may be determined from time to timein accordance with the income from theendowment.

Note:

Your submission should include the objectives of the project, method of study, a statementas tohowthisprojectrelatestothecareeraspirationsoftheapplicant,thesupervisor’sname and address and estimated costs of the project. Each application must also include a copyof the applicant’s curriculumvitae.

Fillinallsectionsoftheformandattachanydocumentsorstatementstosupportyour application. Return the application form to the Dr Nick Cooling, Director of Electives, School of Medicine, UniversityofTasmania, Private Bag 34, Hobart TAS7001.

Email –

Applications close on 1 April 2016. Late applications will not beaccepted.

NAME: ADDRESS:

ELECTIVETITLE:

PROPOSED DATES FORELECTIVE: ELECTIVE TO BE UNDERTAKENAT:

PLEASE ATTACH CONFIRMATION OFARRANGEMENTS.

SIGNATURE DATE: