Energy Renaissance Innovator Award Application FormPlease enable JavaScript in your browser to complete this form.Personal Information1. Name *FirstLast2. Email *3. Phone Number (your preferred contact number) *Are you a member of the ABS? *YesNoTell us a bit about yourselfGeneral Information4. University/Institute/Company *5. Supervisor / Manager *Please enter your academic supervisor (university/tafe) or direct line manager.6. Study/Thesis topic/Title *7. Battery Technology *a. Lithium - ionb. Lead - Acidc. Na - iond. otherIf you selected (d) in question number (7), please specify which other battery technology. 8. Battery value chain domain which you are applying in *a. Battery minerals, discovery to recovery, beneficiation of minerals (e.g. spodumene to LiOH / Li2CO3)a. Battery minerals, discovery to recovery, beneficiation of minerals (e.g. spodumene to LiOH / Li2CO3)b. Battery Chemistry, i.e. cathode, anode, electrolyte, separator materials developmentc. Prototyping of batteries i.e. cell fabrication and testingd. Design of battery packs, multiple cells wired together, development of safety and control systems, such as battery management systemse. Deployment and use of batteries, i.e. energy storage on the grid, vehicles, disruptive mobility, etc.f. Recycling of batteries, second life of batteries, cell recycling, materials recyclingg. Other: policy, education and training, social license to operate, techno economics of battery materials and batteries9. QualificationsYearQualificationInstitutionYear Qualification Institution Year QualificationInstitution Year Qualification Institution Year Qualification Institution 10. AwardsYear AwardInstitution Year Award Institution Year Award Institution Year AwardInstitution Year Award Institution Your Application11. Application Title *12. Summary of the Proposed Activity *13. Why do you want to do this Project? *14. What new knowledge and/or skills do you hope to gain from this Award? *15. Does your application include conference attendance? *YesNoName the conferenceDates of attendanceRegistration FeeUpload a brochure with the conference details OR Website link Click or drag a file to this area to upload. 16. Does your application include overseas travel? *YesNoWhere else do you intend to visit / study as part of your Award? 17. How will your Award benefit the development of Battery technologies in Australia? *18. How will you disseminate the learnings from your Award? *19. Please upload your personal reference for your application (PDF) * Click or drag a file to this area to upload. 2 references (one personal and one professional) that speaks to your application answering the following questions: a. Personal and/or professional qualities of the Applicant b. Applicant’s commitment to continued activities in the battery domain c. Benefit of the Award, personally and professionally, to the Applicant. d. How long have you known the applicant? • What do you think of the applicant’s performance so far? Support with examples eg. medals won, academic achievement, comparison with other students you have supervised • How would you describe the applicant’s attitude towards their research? Support with examples eg. self-motivated, works hard, time management skills, talented, visionary, original, enthusiastic • How well do you think the applicant will perform in the future? These should be in pdf format and no more than 1 A4 page. *Applications without two references will not be accepted.20. Please upload your professional references for your application (PDF) * Click or drag a file to this area to upload. 2 references (one personal and one professional) that speaks to your application answering the following questions: a. Personal and/or professional qualities of the Applicant b. Applicant’s commitment to continued activities in the battery domain c. Benefit of the Award, personally and professionally, to the Applicant. d. How long have you known the applicant? • What do you think of the applicant’s performance so far? Support with examples eg. medals won, academic achievement, comparison with other students you have supervised • How would you describe the applicant’s attitude towards their research? Support with examples eg. self-motivated, works hard, time management skills, talented, visionary, original, enthusiastic • How well do you think the applicant will perform in the future? These should be in pdf format and no more than 1 A4 page. *Applications without two references will not be accepted.DeclarationsI have read and accept the Privacy Statement and Application Guidelines *YesI understand that my referees may be contacted by the ABS as part of the selection process *YesI state that the information provided is true and correct. I accept that the ABS has the right to reject an application or retract the award, on the basis of false or misleading information forming any part of the Energy Renaissance Innovator Award application. *YesSubmit
