Advanced Course: Scholarship Application Form

Advanced Course: Scholarship application form

Banana research in Africa: Modern breeding techniques, regulatory and biosafety issues

September19, 2016–September30, 2016

With support of

Admission requirements:

• Holder of Bachelor (or equivalent) in Science, Plant Biotechnology, Agricultural or Bioengineering Sciences
• Good knowledge of English

Preference will be given to participants from Africa involved in breeding bananas.A balance between male and female participants will be achieved.

Application deadline: May 31th, 2016

Please read this information carefully before completing the scholarship application form:

Scholarship eligibility criteria

The participants must meet the following criteria:

1) STI-scholars must be nationals and residents in one of the 54 countries with which VLIR-UOS cooperates in its scholarship programme. The 54 countries include:

Africa: Benin, Burkina Faso, Burundi, Cameroon, DR Congo, Ethiopia, Gambia, Ghana, Guinea, Ivory Coast, Kenya, Madagascar, Malawi, Mali, Morocco, Mozambique, Nigeria, Rwanda, Senegal, South Africa, Tanzania, Togo, Tunisia, Uganda, Zambia, Zimbabwe.

Asia: Bangladesh, Cambodia, India, Indonesia, Jordan, Laos, Nepal, Palestinian Territories, Philippines, Sri Lanka, Thailand, Vietnam.

Latin America: Bolivia, Brazil, Colombia, Cuba, Dominican Republic, Ecuador, Guatemala, Guyana, Haiti, Honduras, Mexico, Nicaragua, Paraguay, Peru, Surinam, Uruguay.

2) VLIR-UOS targets applicants from research institutes, higher education institutes, the government sector (national/subnational), the sector of social economy, an international organization or an NGO, with expertise in matters relevant to development. Applicants from the commercial profit-sector without expertise in matters relevant to the development of a country are not eligible.

3) Previous applications and scholarships

 A candidate can only receive 1 VLIR-UOS-scholarship per year

 A candidate who was awarded a VLIR-UOS-scholarship before to participate in a ICP, ITP or STI can only be awarded a scholarship to participate in the STI if the STI has a thematical connection with the previously followed programme.

The scholarship application form should be completed, signed and returned by e-mail to:

Sylvie De Buck

Course “Banana research in Africa”September2016 Uganda

Ghent University

E-mail:

The applicants that are selected for a scholarshipwill be notified by email by the end of June 2016

1. Personal Information

Family name (surname)
Maiden and/or any other names that may have been used on documents
First name (given name)
Sex (male/female)
Place of birth (town, country)
Date of birth
Nationality at birth
Current nationality
Passport number
Passport valid until
Familial status (single, married, divorced)
Number of children
Current (private) address (for correspondence regarding this application)
Name of contact person (if applicable)
Street and number
Postal code, city, state
Country
Telephone
(country code – area code – phone number)
Fax
(country code – area code – phone number)
e-mail
Professional/working address
Institution
Department
Street and number
Postal code, city, state
Country
Telephone
(country code – area code – phone number)
Fax
(country code – area code – phone number)
e-mail
If you prefer this address for correspondence mark here

1. Education

Post-secondary education or university studies
Period
From (dd/mm/yy)
To (dd/mm/yy) / Name and Address of Institution / Name of studies / Language used / Qualifications obtained / Grade/results
Other studies, workshops, etc. (chronological)

1. Language skills

Mother tongue
Other languages: indicate with a number from 1 to 5 the degree of your knowledge
1 = native speaker, 2 = excellent, 3 = good, 4 = weak, 5 = no knowledge
English / French / Dutch / German / Spanish / … / …
Speaking
Writing
Reading
Understanding

1. Scholarship history

If applicable, list the scholarships and grants you received previously (in your own country and/or abroad)

Period
From (dd/mm/yy)
To (dd/mm/yy) / Name and address of the organization which issued the scholarship / Studies performed
Institution, country, name of studies

1. Professional experience (chronological, including present position)

Period
From (dd/mm/yy)
To (dd/mm/yy) / Name and address of employer
Name of supervisor
Fax and telephone number / Position (job title) and description of responsibilities (in the case of research or teaching, specify the subjects) / Sector (education, industry, NGO, etc.)

1. Additional information

(provide any useful additional information supporting your application)

use additional pages if needed

Motivation for attending the course:

Relevance for your institution:

What is your experience with banana or crop improvement programs? Are you involved in local biotech regulatory programs?

Co-ordinates of 2 persons that can act as reference:

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