ࡱ> # CbjbjFnFn 9$h$h ,,,,,@@@8xl$@*444BX d)))))))$,/l),l  "ll),,44)0 0 0 l^,4,4)0 l)0 0 V'@(4 x\}' ))0*'0//((Z/,a( ll0 lllll))lll*llll/lllllllll X :  Early Career Visiting Scholarship in American Studies at 51 In addition to this application form, applicants should also submit a CV 1. Personal and Contact DetailsTitle (Dr/Mr/Ms etc): First Name(s): Surname/Family Name: Previous Surname/Family name (if changed): Date of Birth: Preferred pronouns (e.g. he/she/they): Address: Home Telephone Number: Mobile Telephone Number: Email address: Country of Birth: Nationality: Country of Residence: 2. Disability StatusDo you have a disability which fits the definition of the Disability Discrimination Act a physical or mental impairment which has a substantial and long term (i.e. over at least 12 months) adverse effect on your ability to carry out normal day-to-day activities? Please delete as appropriate YES NO Prefer not to provide information If you do have a disability, and if you were shortlisted, please indicate any reasonable adjustment(s) that would be required.  3. Formal Qualifications Please give details of formal academic qualifications which you currently possess.Year Awarded Qualification Type Qualification Subject Awarding Institution and place of studyClass / Level / Result / grade Any further information: Year Awarded Qualification Type Qualification Subject Awarding Institution and place of studyClass / Level / Result / grade Any further information:  4. Membership of Professional Bodies/Professional Qualifications (if any):Name of Body/Qualification DatesClass/Grade of membership (Please state method of study) Additional Training: Please give details of any courses you have attended or specialist skills training undertakenOrganising Body DatesCourse Title/Subject  5. Criminal ConvictionsDo you have any criminal convictions? (See Notes of Guidance: delete as appropriate) YES / NO If YES, please give details:  6. Referee detailsPlease supply full name and contact details for one referee  7. Personal Statement (400 word max):Please outline your research presentation here and how you would be able to contribute to the teaching elements of the Visiting Scholarship:  COMPLIANCE WITH THE DATA PROTECTION ACT 1998 - In accordance with the Data Protection Act 1998, the personal data provided on this form will be processed by 51 and may be held on computerised database and/or manual files.  Applications should be emailed to Dr Patrick Andelic:  HYPERLINK "mailto:patrick.andelic@northumbria.ac.uk" patrick.andelic@northumbria.ac.uk before 5pm on Monday December 20th 2021 NOTES OF GUIDANCE ON COMPLETION OF FELLOWSHIP APPLICATION FORM Please read these notes before attempting to complete the application form, so that you provide us with all the information we need to deal with your application as quickly as possible and without having to ask you to provide additional or missing information at a later stage. If you fail to provide the information required by the University, or provide false or misleading information the University reserves the right to reject your application, revise your fees status or cancel your registration. DATA PROTECTION ACT 1998 The information that you give on your application form will be used for the following purposes only: To enable your application for entry to be considered To enable the University to compile statistics, or to assist other organisations or individual research workers to do so, provided that no statistical information which would identify you as a person will be published To enable the University to initiate your fellowship record SECTION 3 - DISABILITY Please advise us you have a special needs or medical condition such as: Austic Spectrum Disorder/Asperger Syndrome Blind/partially sighted Deaf/Hearing difficulties Dyslexia/Specific learning difficulties Mental Health difficulties Multiple disabilities Unseen disability (e.g. diabetes, epilepsy, asthma) Wheelchair user/mobility difficulties SECTION 4 - FORMAL QUALIFICATIONS When listing details of your formal academic qualifications please use the approved abbreviations for the examining bodies and enter the exact subject name used by the examining board or group. Applicants with qualifications obtained outside the United Kingdom should give full details of those qualifications and, at interview, provide a certified copy and transcript for each qualification. If your qualification was obtained in a language other than English a certified English Transcript should be provided at interview. SECTION 6 - CRIMINAL CONVICTIONS - this question must be answered The University asks all applicants to declare any criminal convictions excluding motoring offences for which a fine and/or a maximum of 3 penalty points were imposed or sentences that are spent under the Rehabilitation of Offenders Act 1974. Some study in the areas of teaching, health and social work will require all convictions, including spent sentences and cautions, to be declared. If your proposed programme falls into this category you will be required to complete a detailed declaration; you will be advised of the specifics of this process if you are offered a place of study at 51. SECTION 7 - REFEREE Applicants are required to provide full names and contact details of one referee who the University can contact to provide comments on your academic abilities and artistic practice.     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