Geographical Association - GA International Initiatives Fund

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GA International Initiatives Fund - Online Application Form

* = compulsory

Name: *

Address Line 1: *

Address Line 2:

Address Line 3:

Post Code: *

Country: *

Telephone 1: *

Telephone 2:

Fax:

Email: *

Sex: *

Nationality: *

1. Profession. What position(s) do you currently hold? *

2. Please give a brief summary of any work you have done which is relevent to this application. *

3. Conferences attended in last three years with focus of each and dates: *

4. Are you a member of the GA? *

Yes No

If not a member, are you a member of an equivalent organisation in your own country? If so please provide name and address of organisation:

5. (a) Describe your proposed project / conference visit and outline your aims and intended outcomes. Include details of how you intend to disseminate the knowledge gained to your collegues / own subject association: *

(b) How could Geographical Association members benefit from your award? *

6. Have you received an award of any sort from the GA before? *

Yes No

If yes, please give dates and details:

7. Total amount requested: *

Please give brief details of the breakdown. For example travel costs, accommodation, conference fees: *

8. If you are applying to any other organisations for funding please give brief details here: *

9. For overseas applicants. Have you any contacts in the UK who will be able to help with your arrangements, travel, accomodation etc.? If so, please give name(s), address(es), phone number(s) and email address(es):

10. Supporting Information. Please add any information which you think may be of use to the awarding panel:

11. Supporting Reference.
Please ensure that a supporting reference is sent as soon as possible. This can be sent via email to Frances Soar.

Name of Referee: *

Institution: *

Position held: *

Address Line 1: *

Address Line 2:

Address Line 3:

Telephone: *

Fax:

Email: *

Data Protection: Any personal information you provide will be for GA use only.

If you are applying on behalf of a named overseas applicant please ensure that the applicant has a copy of this form and is fully conversant with the terms of the award.

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