Application form - The Soulsby Foundation

You may apply for a 2019 Soulsby Fellowship between 1 November 2018 and midnight (GMT) on 31 January 2019.

Please apply online using the form below or download the form using these links:

Download and print the application form (Microsoft Word format) ↓

Download and print the application form (Adobe PDF format) ↓

Applicants should note that, for the purposes of applying for a Soulsby Foundation Fellowship, the board has adopted the following definition of One Health:

“One Health focuses on the interdependence between the health of livestock, humans, wildlife and the environment and the importance of this inter-relationship in framing research questions, policy and practice. While there is no universally accepted definition of One Health, interdisciplinary collaboration and systems-level approaches lie at its core. For the purposes of this funding opportunity, successful applications are likely to be those which propose research projects which integrate knowledge from animal and human health and have the potential to improve our understanding of disease in man and animals. This includes consideration of the socio-economic aspects and environmental impacts of those diseases which are relevant to animal and human health.”

All applications will be assessed against this definition.

Name of applicant
Title*
- Dr.
- Prof.
- Mrs.
- Miss.
- Mr.
- Other.
First name*
Last name*
Job title*
Contact details
Full postal address*
Email*
Enter Email Confirm Email
Telephone number (with extension if relevant):
Mobile phone number*
Affiliated Institution
Name of Affiliated Institution*
Full postal address*
Web URL*
Relationship with the Affiliated Institution*
Please provide details - employee/registered student/other (please specify)
Name of supervisor/laboratory head/department chair*
Email address*
Telephone number*
Qualifications and professional experience
Qualifications*
Please include institutions and dates – degrees, diplomas, post graduate experience
Professional experience*
Add further lines using the + symbol to the right
Dates Employer/Organization Position
Publications and presentations*
Please list up to FIVE of your key publications or presentations relevant to this application
Proposed Project
Short title (no more than 25 words)*
Project description*
Please describe (in no more than 850 words) how you propose to use the Soulsby Fellowship. You should briefly summarise the objectives of your project and the methods to be used, and indicate how the project will promote and impact the concept of One Health and how the experience will enhance your career.

Please indicate any relevant contacts you have already established but do NOT try to attach any evidence. This evidence may be requested by the Trustees if your application is short-listed. The Board will also require evidence of appropriate ethical review approvals from successful applicants.
Personal Statement*
Please describe (in 250 words or less) why your life experiences make you a good candidate for a Soulsby Fellowship
Budget
Proposed total budget
Add further lines using the + symbol to the right
Item Amount
Total Budget (UK£)*
Amount requested from the Soulsby Foundation (UK£)*
Please note:

The Fellowship award will be made in UK £ sterling. Allowable expenses may include: economy travel (airfares and any transfers), visas, insurance and accommodation.
Source(s) of further funds (UK£)*
Please list potential sources of further or matching funds, indicating whether a decision has been made and/or whether the award is contingent on your succeeding with this application. Add further lines using the + symbol to the right.
Organization Amount requested Expected decision date Notes
References

Please give below the name and contact details of two people who may be asked to act as referees for you. They will be expected to have authoritative and personal knowledge of your professional achievements / competencies. If you are short-listed, referees may be contacted directly by the Soulsby Foundation.
Referee 1
Name*
In what capacity, and over what period of time, has this individual known you?*
Phone*
Email address*
Referee 2
Name*
In what capacity, and over what period of time, has this individual known you?*
Phone*
Email address*
Before submitting this application, please read the guidelines to make sure you are a qualified applicant.

Please complete your application and submit it no later than midnight (GMT) on Thursday 31 January 2019
Please indicate how you heard about Soulsby Fellowships e.g. through a journal, website, personal contact, etc. Please be as specific as possible to enable us to improve publicity about Soulsby Fellowships. Thank you.*
Sharing your information*
Please tick this box to confirm you accept that the Soulsby Foundation will hold the information you submit and may share this information solely for the purposes of assisting you with your enquiry or application.
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Name of applicant

Contact details

Affiliated Institution

Qualifications and professional experience

Proposed Project

Budget

References

Referee 1

Referee 2