项目申请表（CAS-CSIRO EXCHANGE PROGRAM 2019）.docx

CHINESE ACADEMY OF SCIENCES (CAS) & AUSTRALIAN COMMONWEALTH SCIENCETIFC AND RESEARCH ORGNIZATIOIN (CSIRO) SCIENTIFIC COOPERATION PROGRAM FORM OF APPLICATION 2019 1. Title of research proposal: 2. Full name and title of applicant: 3. Date and place of birth: 4. Affiliation and business address: 5. Telephone and email: 6. Field of specification: 7. Brief education and employment experience: 8. English language competence (functional, good and excellent): A. Listening: B. Reading: C. Speaking: D. Writing: 9. Attach list of publication (last five years): 10. a) Previous visit(s) to Australia (if any) and collaboration: b) If YES, how is this visit additional or complementary to previous visits: 11. List the Australian institutes the applicant desires to visit: 12. Proposed duration of visit: 13. Attach copy of correspondence with Australian host(s): 14. Summary of proposal: 15. Research plan: 16. State why the work should be best carried out in Australia and how it would benefit China: 17. References (at least three with name, address and telephone number): _____________________________ (Signature of applicant) Date: