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PH.D.PLUS SCHOLARSHIPS 2011

                                              Annex 1

                                        APPLICATION FORM


A. Fill in the following box

Personal data
Family name
Name
Nationality
Birth Date
Gender (F/M)
Phone
E-mail
Ph.D. data
University that awarded the Ph.D.
Title of Ph.D. degree
Month and year in which the Ph.D.
was awarded
VLIR-UOS programme in which the
Ph.D. was earned (if applicable)
Ph.D.Plus project data (max. 3 months)
Title Ph.D.Plus project
Flemish university where the
specialisation will take place
Flemish promoter
Desired start date of stay
Desired end date of stay


B. Answer questions 1° to 8° by filling in the boxes below each question. Respect the limitations as
   indicated. Do not add additional space or boxes. Do not attach annexes.

1° Profession – What is your current professional occupation and where do you perform it? (max.
   3 lines)




                                   Ph.D. PLUS SCHOLARSHIPS 2011
                                     Annex 1 – Application form
                                                 1
2° Ph.D. research – What was your Ph.D. dissertation about? Provide a short summary (max. 5
   lines)




3° Specialisation scholarship motivation – Why do you want a Ph.D.Plus scholarship? (max. 5
    lines)




4° Specialisation project outline – What do you want to use the scholarship for in terms of the
   expected output / outcome of your activities at the Flemish university? (max. 15 lines)




5° Extension, utilisation – How will you utilise the knowledge / experience you acquire in your
    home country? (max. 5 lines)




6° Ph.D. connection – What is the connection between the specialisation project and your Ph.D.?
   (max. 3 lines)




                                 Ph.D. PLUS SCHOLARSHIPS 2011
                                   Annex 1 – Application form
                                               2
7° Project connection – Is there any connection to other (ongoing) projects (funded by VLIR-UOS
   or others)? (max. 5 lines)




8° Supervision – Who is your Flemish promoter and what role does this promoter have in your
    specialisation project? (max. 5 lines)




C. Find a Flemish professor who is willing to act as your promoter.

   Enclose a letter of recommendation (free format, scanned) by that promoter, in which reference
   is made to the planned specialisation project and the way in which you and the promoter will
   collaborate with the aim of producing the output concerned.




                                    Ph.D. PLUS SCHOLARSHIPS 2011
                                      Annex 1 – Application form
                                                  3
Ph.D. PLUS SCHOLARSHIPS 2011
  Annex 1 – Application form
              4

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Ph d plus_scholarships_2011_application_form

  • 1. PH.D.PLUS SCHOLARSHIPS 2011 Annex 1 APPLICATION FORM A. Fill in the following box Personal data Family name Name Nationality Birth Date Gender (F/M) Phone E-mail Ph.D. data University that awarded the Ph.D. Title of Ph.D. degree Month and year in which the Ph.D. was awarded VLIR-UOS programme in which the Ph.D. was earned (if applicable) Ph.D.Plus project data (max. 3 months) Title Ph.D.Plus project Flemish university where the specialisation will take place Flemish promoter Desired start date of stay Desired end date of stay B. Answer questions 1° to 8° by filling in the boxes below each question. Respect the limitations as indicated. Do not add additional space or boxes. Do not attach annexes. 1° Profession – What is your current professional occupation and where do you perform it? (max. 3 lines) Ph.D. PLUS SCHOLARSHIPS 2011 Annex 1 – Application form 1
  • 2. 2° Ph.D. research – What was your Ph.D. dissertation about? Provide a short summary (max. 5 lines) 3° Specialisation scholarship motivation – Why do you want a Ph.D.Plus scholarship? (max. 5 lines) 4° Specialisation project outline – What do you want to use the scholarship for in terms of the expected output / outcome of your activities at the Flemish university? (max. 15 lines) 5° Extension, utilisation – How will you utilise the knowledge / experience you acquire in your home country? (max. 5 lines) 6° Ph.D. connection – What is the connection between the specialisation project and your Ph.D.? (max. 3 lines) Ph.D. PLUS SCHOLARSHIPS 2011 Annex 1 – Application form 2
  • 3. 7° Project connection – Is there any connection to other (ongoing) projects (funded by VLIR-UOS or others)? (max. 5 lines) 8° Supervision – Who is your Flemish promoter and what role does this promoter have in your specialisation project? (max. 5 lines) C. Find a Flemish professor who is willing to act as your promoter. Enclose a letter of recommendation (free format, scanned) by that promoter, in which reference is made to the planned specialisation project and the way in which you and the promoter will collaborate with the aim of producing the output concerned. Ph.D. PLUS SCHOLARSHIPS 2011 Annex 1 – Application form 3
  • 4. Ph.D. PLUS SCHOLARSHIPS 2011 Annex 1 – Application form 4