Application Form for a Scholarship awarded by the University of Fribourg Academic Year 2012-2013 Reseach Stay at PhD LEVEL / Application Deadline February, 28th 2012 for a stay during Autumn Semester (Term) 2012 (September 2012 to February 2013) September, 30th 2012 for a stay during Spring Semester (Term) 2013 (February 2013 to July 2013) Reseach Stay at POST- PhD LEVEL / Application Deadline February, 28th 2012 for a 1 to 3 months stay starting 3 months after this deadline date September, 30th 2012 for a1 to 3 months stay starting 3 months after this deadline date To be filled in 2 copies (no handwritten forms) Niveau Doctorat Doktoratsebene Dossier reçu le: Unterlagen erhalten am : Not fill in Niveau Post-Doctorat Post-Doktoratsebene Dossier reçu le: Unterlagen erhalten am : Dossier complet: Vollständige Unterlagen: Dossier incomplet: Unvollständige Unterlagen: Dossier complet: Vollständige Unterlagen: Dossier incomplet: Unvollständige Unterlagen: PHOTO I. PERSONAL DATA 1. Surname (Family Name) : 9. Address : 2. First Names : Address 3. Date of Birth (dd/mm/yy) : 4. Nationality : Zip Code City State Country 5. Phone Number : 10. Name and address of a person to be contacted in the home country in case of an emergency : Name / Address 6. Fax Number : 7. Email: 8. Gender : Male Female Zip Code City Country Phone Number Email 11. Marital Status : 12. Children : single married no yes* divorced widowed *if yes, how many?
II UNIVERSITY EDUCATION (UNIVERSITIES COLLEGES DIPLOMAS) 1. For candidates to a reseach stay at PhD LEVEL (For candidates to a research stay at POST-PhD LEVEL go to point 2.) 1.1. Bachelor Degree a or equivalent first University Diploma Year of completion of the Degree : Grades or Marks : 1.2. Master Degree or equivalent University Diploma Year of completion of the Degree : Grades or Marks : 1.3. Registration for the PhD (Study in Progress) Registration Date fort the PhD (at least since 2 semesters) : Titel of the Thesis : Name of the Professor (Thesis Director) : Foreseen Graduation Date : 1.4. Letter of Acceptance of the Professor at the foreign University (Thesis Director) Home Name of the Professor :
1.5. Brief despcription of the Research Project to undertake at the University of Fribourg : 2. For candidates to a research stay at POST-PhD LEVEL 2.1. PhD Degree Titel of the PhD Thesis : Year of completion of the Degree (at least within the last 3 years) : Grades or Marks : 2.2. Letter of Acceptance of the Professor at the University of Fribourg who commits to welcome the searcher in his Research Group : Name of the Professor : 2.3. Brief description of the Research Project to undertake at the University of Fribourg : 2.4. Scientific articles, Publications or former University Research Results :
III LANGUAGE PROFICIENCY 1.1. Mother Tongue : 1.2. Foreign Languages : Number oy Years : Certificates- Diplomas : Level *: French German Italian English Others * If no language diploma: excellent, good, average, little IV STAYS ABROAD 1. Foreign Study Stays no yes * *if yes, which and where? Type and Reasons of stay : Duration - from / to : University + City/Country : 2. Professional Stays no yes * * if yes, which and where? Type of Activity : Duration - from / to : Employer :
V STAY AT THE UNIVERSITY OF FRIBOURG Academic Year : 2012-2013 Autumn Semester (Term): 2012 Spring Semester (Term): 2013 Foreseen Months : Reseach at PhD LEVEL : (4 6 maximum) Research at POST PhD LEVEL: (1-3) Dates of Stay for Research : from to Faculty (School) : Departement Institute : Is there a cooperation between the foreign University and the University of Fribourg?: No yes * *if yes, which one? By its signature, the person mentionned above certifies that the informations and declarations are complete and true. The person confirms that, in case of being awarded the Scholarship of the University of Fribourg, she will comply with the rules and obligations granted by it. Otherwise the person can definitely be excluded from the University of Fribourg. Place : Date : Signature : IMPORTANT 1. Diplomas and official Letters must be enclosed in the files as certified copies of the originals, or if needed with translations. The accepted official languages for translations are English, French, German or Italian. When enclosed documents are in another language, only translations made by an official translator are accepted and documents must be legalized. 2. The mandadory deadline to hand in the Application files must be respected. 3. The Application files must be sent to the International Relations Office by email and postal mail. Address : Université de Fribourg Service des relations internationales 20, Avenue de l Europe - CH 1700 Fribourg Suisse - 4. Only complete Application files will be processed. 5. No correspondance will be held once the files have been received. 6. The selection sessions on the application files are held in March and October respectively. 7. Candidates will be informed of the decision of the Rectorate directly by email.
CHECKLISTE (DOCUMENTS TO BE ATTACHED TO THE APPLICATION) The Application file must enclose the following documents in the order indicated below Research Stay at PhD Level Filled Application Form + ID Picture (JPEG Format) Curriculum Vitae (Resume) Bachelor Degree or first equivalent University Diploma from a University which is acknowledged by the University of Fribourg Master Degree or equivalent University Diploma from a University which is acknowledged by the University of Fribourg Transcript of Records - Study Records with marks and/or grades Confirmation Letter of the foreign University certifying the registration to the PdD Degree since 2 semesters (terms) at least Letter of Acceptance of the Professor (Thesis Director) of the foreign University Detailed Research Project at the University of Fribourg Explicative regarding the necessity of a Scholarship for the acomplishment of the Research Project Residence Certificate Passport Copy Research Stay at POST-PhD Level Filled Application Form + ID Picture (JPEG Format) Curriculum Vitae (Resume) PhD Degree Diploma completed within the last 3 years Detailed Research Project at the University of Fribourg Letter of Acceptance of the Professor at the University of Fribourg who commits to welcome the searcher in his Research Group Copies of scientific articles, publications or former university research results Explicative regarding the necessity of a Scholarship for the acomplishment of the Research Project Residence Certificate Passport Copy