Application form

Applications for the Hugh Martin Weir Prize will close on 28 February 2025. Applicants will be notified of the outcome by 31 March 2025.

Personal details

ID number

Title

Family name

Given name/s

Gender

Date of birth

Phone number

Email address

Home address

Semester postal address (if different from above)

Please provide a short statement outlining how receiving the Prize will benefit you

Qualifications and study

Undergraduate studies

Re-order	Qualification	Level of Honours obtained	Institution/University	Date commenced	Date completed/completion expected	Weight	Operations
	Qualification	Level of Honours obtained	Institution/University	Date commenced	Date completed/completion expected	Item weight

more items

Postgraduate studies

Re-order	Qualification	Institution/University	Date commenced	Date completed/completion expected	Weight	Operations
	Qualification	Institution/University	Date commenced	Date completed/completion expected	Item weight

more items

Study or research proposal

Please provide a brief statement of your proposal for study or research and attach extra pages if required

One file only.
20 MB limit.
Allowed types: txt, html, pdf, doc, docx, ppt, pptx, rar, zip.

Details of referee

You are required to arrange a confidential referee’s statement in support of your application. Please attach the completed referee statement and provide us with the following details:

Referee's name

Position title

School/Organisation

Address

Phone number

Email address

One file only.
20 MB limit.
Allowed types: pdf, doc, docx, rar, zip.

Declaration

I declare that the information I have supplied on this form is true and correct to the best of my knowledge.
I have read and accept the Rules of the Prize.
I understand that the Prize may be cancelled if it is proven that I was offered a Prize based on false or misleading information or documentation.
I authorise the University of Adelaide to obtain such additional information deemed necessary to assess my application for this Prize.
I understand that the University will not disclose any information supplied on the application form, or obtained for the selection process, without my written consent.
The information supplied will only be used for the selection process of this Prize and will be managed in accordance with the University of Adelaide Privacy Policy and Management Plan.

I agree