2008/2009 Vacation Research Experience Scholarship Application


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Applications must be submitted no later than 3 October 2008. Please contact 07 3138 1000 or infotech.research@qut.edu.au if you are having difficulty submitting this form or need to include further information.

Name	* *
Male/Female
Date Of Birth
QUT Student Number
Address QUT students please note we will use your address details on QUT Virtual
Contact Number	*
Alternative Contact Number
Email	*
Course Currently Enrolled
Current Course GPA
Please upload a copy of your academic transcript if your results are not available on QUT Virtual
Summary of Work Experience
Staff member with whom you wish to work Note: You must contact a staff member and obtain their agreement before you submit this form
Research Project Note: If the research project you wish to work on is not listed please select “other” and add your project to the comments section below
Academic Referees Note: referees are requested to send an email of support for your application to: infotech.research@qut.edu.au
Comments

* fields marked with an asterisk are mandatory.