Section A: Personal Details

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* 1. Family name

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* 2. First name

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* 3. Gender

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* 4. Title (e.g. Professor, Doctor, Mr, Mrs, Miss, Ms)

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* 5. Country of residence

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* 6. Current position

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* 7. Current institution/university

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* 8. Address for correspondence

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* 9. Contact number

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* 10. Email

Section B: Fellowship details

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* 11.
Name and email of proposed University of Liverpool mentor/ host for the Fellowship.

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* 12.
Proposed start date (the Fellowship includes mentoring and training components; we expect most Fellowships to last between 3 -6months ). 

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* 13.
Summary (maximum 250 words) of the proposed project including objectives and proposed outputs.

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* 14.
Name and email of Head of Department or Supervisor from your home institution supporting this application


Section C. Confirmation of application 

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* 15.
I confirm that I wish to apply for a Fellowship under the University of Liverpool's International Fellowship programme. If successful, I undertake to observe any Fellowship award conditions including offering a public lecture virtually (or equivalent presentation)  about my research and to prepare a final report on my activities at the end of the Fellowship.

The University of Liverpool will process your personal data as part of your Fellowship. This will be done in the legitimate interests of the University and in accordance with our Policy notice for Employees and Other Personnel.

Signing the above box confirms I agree with the above statement.
Section D. Supporting documents
Please upload the following documents:

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* 16. Fellowship proposal

PDF, DOC, DOCX file types only.
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* 17. CV/resume (maximum two pages plus an additional page for publications)

PDF, DOC, DOCX file types only.
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* 18. Supporting statement from your home institution

PDF, DOC, DOCX file types only.
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Thankyou for completing the application form. We will be in contact soon with the outcomes. In the meantime if you have any queries please contact claire.kidman@liverpool.ac.uk

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* 19. Supporting statement from the proposed mentor/host at University of Liverpool

PDF, DOC, DOCX file types only.
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