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STUDENTSHIP APPLICATION FORM

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COMPLIANCE WITH THE DATA PROTECTION ACT 1998
In accordance with the Data Protection Act 1998, the data provided on this form will be processed by Great Western Research, and may be held on computerised database and/or manual files. Further details may be found in the guidance notes, Appendix 1
Please ensure you have read and understood the Guidance Notes
* Denotes compulsory fields  
* Theme:
* Project Title:  
THE APPLICANTS:  
* Host Institution:
  QAA Compliant?
* Department:
* 2nd Institution:
* Department:
Other HEI:
* Lead External Partner:  
* Lead External Partner address: 
* Nature of Business:
 Charity   Public   SME   Significant Regional Employer 
* Has the business partner(s) sent the commitment letter to GWR?: Yes No
Supporting External Partner(s):  

Name & Address: 
Nature of Business:  
 Charity   Public   SME   Significant Regional Employer 
TOTAL VALUE:  
* Total cost of studentship (£)
* Total contribution from Lead External Partner (£)
Total contribution from supporting external partners (£)
Total contribution from external partners (£)
Explanation if less than 50% (e.g. balance to be provided by School or University funds)
Additional contribution (amount and source) (£)
* Total required from GWR (£)
 
THE PROJECT:  
* Proposed Start Date :
(dd/mm/yyyy)
* Proposed Finish Date :
(dd/mm/yyyy)
* Project Description (Try to limit to 1000 words. You can paste from Word if preferred):
* Project Abstract: Describe the proposed research in a way that could be publicised to a general audience (try to limit up to 250 words):
* Alignment with proposed theme (max. 500 words): 
* 'Nature of the proposed collaboration, describing clearly proposed working relationships (max. 500 words): 
* Is the research linked with other GWR studentship applications?: Yes No
Please outline the links with other GWR applications (max 250 words): 
SUPERVISION:  
* Lead HEI supervisor
* Email:
* Address: 
* Telephone:
* Experience of working with business:

- Never

- Rarely
(less than 3 times)

- Often
(more than 3 times)
* Relevant Academic Experience: 
* 2nd HEI supervisor
* Experience of working with business:

- Never

- Rarely
(less than 3 times)

- Often
(more than 3 times)
Other HEI supervisor
Experience of working with business:

- Never

- Rarely
(less than 3 times)

- Often
(more than 3 times)
*Proposed arrangements for inter-Institutional supervision (max 250 words):

SW Economic Benefits:
The application must explain how the proposed research project will benefit the economy of the South West, and illustrate how the benefits of the research activity will be captured and exploited within the region. You are strongly advised to read the guidance notes available.
Please tick each box you complete and give details of the anticipated impact of your proposal.

Additional R&D expenditure in the region
Details (max 500 words):
Helping an organisation develop a new technology or process
Details (max 500 words):
Improving systems or techniques within the region
Details (max 500 words):
Enhancing information about the SW
Details (max 500 words):
Other
Details (max 500 words):
OTHER BENEFITS:  
*What benefits are there for the external partner (including potential monetary value)?
* Has the partner worked with the HEI sector previously?
 Yes No
Please give details of partners Previous collaborations with HEIs (max 200 words):
* What potential is there for future research collaboration? Please be as specific as Possible (max 500 words)
* Test Field
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