FROGBEAR Cluster Visit Application Form 2019 Please submit your application before January 21, 2019. Thank you for your application. Your personal information is collected under the authority of section 26(c) of the Freedom of Information and Protection of Privacy Act (FIPPA). This information will be used 1) to communicate the project's activities to you, and 2) for the purpose of evaluating the project “From the Ground Up: Buddhism and East Asian Religions”. Information is reported to our sponsors in aggregate form only and is not shared with other parties. Questions about the collection of this information may be directed to Frogbear.firstname.lastname@example.org. Please select which cluster(s) you are applying to:*Full descriptions can be found at http://frogbear.org/field-trips/cluster-field-trip-plans/clusters-in-phase-1-2017-2019/ Cluster 1.2 Religion and Technology Cluster 2.1 Authenticity and Authority Cluster 2.2 “Secondary” Producers, “Primary” Roles / Cluster 2.5 From the Canonical to the Post-canonical Cluster 3.2 Historical Reality through the Reflections between Image and Text: Northern Dynasties Buddhism and Beyond Cluster 3.3 Texts in Statues Name* First Last Gender*The FROGBEAR project is committed to gender equity. This information will be used to improve internal processes. Female Male Other Prefer not to answer EthnicityPlease specify the ethnicity(ies) you identify with. The FROGBEAR project is committed to diversity and inclusion. This information will be used to help improve internal processes. Email Address* Affiliated Institution*Current Academic Level*UndergraduateMasterPhDPost-doctoral fellowProfessorOtherPlease specify if you chose "other".Please provide a brief bio, highlighting your research interest in the chosen cluster(s)*Please explain what skills/knowledge you hope to contribute*CV*Please upload a brief CV in Word or PDF format.First Reference's Name*Required for students and post-doctoral fellows only First Last First Reference's EmailPlease have your reference letter sent to Frogbear.email@example.com. Second Reference's Name*Required for students and post-doctoral fellows only First Last Second Reference's EmailPlease have your reference letter sent to Frogbear.firstname.lastname@example.org.