Professional Documents
Culture Documents
Personal Information
Given Name:
Family Name:
Address:
Phone Contact:
Email:
Qualifications
Year of
Academic Qualification University/Institution
Completion
Employment History
Provide employment details here. Please also record career breaks. Add an additional page if required.
Years of Service
Name of Employer Position held and brief description
From To
Curtin University is a trademark of Curtin University Security Classification: PUBLIC CRICOS Provider Code 00301J
of Technology Version date 03-06-16
Research Experience (must be greater than six months)
The following statement describes my research experience in the area relevant to my chosen
field of study. Provide relevant professional experience only if applying for a professional
doctorate.
Please include only those publications and/or exhibition details that are in the area relevant to
your chosen field of study.
(Include title, authors, journal (volume, page), book, book chapter, and date of publications. For
exhibitions, please indicate the role you played in the development of the exhibition. You must
provide quality indicators for all outputs as appropriate for your field)
Please include details of any other supporting information that you consider relevant to your
application e.g. awards, prizes, research grants
Referees
The contact details of two (2) academic referees are provided below.
Referee One
Name:
Position:
Organisation:
Phone Contact:
Email:
Referee Two
Name:
Position:
Organisation:
Phone Contact:
Email: