INTERNATIONAL ACTIVITIES
Australian Academy of Science Scientific visits
Summary sheet
(All fields must be completed)
1. Program: Sub-program
2. Proposed country
3. Address details
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4. Contact details
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5. Date of birth
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6. Name and address of main host
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7. Brief title of proposal
8. Amount of funding requested
| Total $ |
9. Duration of visit
| Number of days |
10. Proposed dates of arrival and departure
(Travel must commence from 1 January 2010 and be completed by 31 December 2010)
| Arrival (Day / Month / Year) |
Departure (Day / Month / Year) |
General
1. Please select your field of science from the following list
2. Please select the most relevant National Research Priority that your research falls under
3. Where did you find out about the Academy's program?