Tempe Mann Travelling Scholarship Please read the Guidelines before completing this form Family Name: Given Names: Date of Birth: Home Address: Home Phone Number: Mobile Phone Number: Email: Degrees held: Current post graduate degree enrolment: Faculty/School: University: Candidature Commencement Date: Expected Candidature Completion Date: Thesis Title: Brief outline of proposed thesis project: Outline of purpose for which the GW-NSW Tempe Mann Travelling Scholarship funds will be used and justification for the travel required (250 words max): Proof of enrolment or acceptance from the university or other institution at which you propose to conduct your short period of research (email or letter): Detailed budget summary for the above purpose (include fares, accommodation, fees, etc): Other financial support granted or applied for: Any additional brief information (optional): Publications: Prizes, scholarships, other awards received: Names, telephone nos. and email addresses of your supervisor and your independent academic referee:
