Application for Admission to the CaSR Biomedicine European Training Network Programme
Please type in English
I. Personal Details
Last Name First Name Middle Name
Date of Graduation (MM-DD-YYYY)*Degree/Title
Current addressCityState/CountryZIP/Postal Code
e-mail Address
CitizenshipPhone Number
II. Education
Indicate the highest level of education you have earned:
Bachelor Master Magister/Diploma M.D.
Highest level of Undergraduate Education
List colleges/Universities where you have earned/expect to receive a degree
College/ University Name Subject area of study
Address
Degree Started (MM-YYYY) Completion Date* (MM-YYYY)
* indicate expected date, if in progress
CaSR Biomedicine Application Form - Page 1 of 9
Additional Education (if applicable)
List additional colleges/Universities where you have earned/expect to receive a degree
College/ University Name Subject area of study
Address
Degree Started (MM-YYYY) Completion Date* (MM-YYYY)
* indicate expected date, if in progress
Additional Education (if applicable)
List additional colleges/Universities where you have earned/expect to receive a degree
College/ University Name Subject area of study
Address
Degree Started (MM-YYYY) Completion Date* (MM-YYYY)
* indicate expected date, if in progress
Please also include the following documents:
Photocopy(ies) of degree(s) and intermediate certificates, if already obtained.
Photocopies of transcripts of marks (academic record).
Special Academic Honours and Awards, including Fellowships:
Native and Spoken languages:
Indicate speaking, reading and writing ability (very high, high, moderate, low)
Technical laboratory experience
List the techniques you have learned and explain in which context you applied them
Additional courses and jobs relevant tothe Multifaceted CaSRProgramme
Please list the courses you have taken and the grades obtained. Please do not exceed this page
List of Publications/Abstracts/Presentation at Meetings (if applicable)
You may attach a resume with more details if needed
Scientific Interests
Please write a short summary of the area of scientific field that you find most interesting, and why. Do not exceed this page.
Preferred research topics / Groups
Chose 1 or 2 scientific fields / research groups (from the 13groups listed in the recruitment advert) and justify your choice.
Why do you want to do this PhD / to participate in this training programme?
Referees
List at least two persons who will write a recommendation letter in support of your application
Referee 1
Last Name, First Initial
College / University, Name and Address of Institution
E-mail Address and Telephone Number
Referee 2
Last Name, First Initial
College / University, Name and Address of Institution
E-mail Address and Telephone Number
Referee 3 (if applicable)
Last Name, First Initial
College/ University, Name and Address of Institution
E-mail Address and Telephone Number
III. Additional requested Information
- Research Experience (Attachment I)
Attach one or two pages on your previous research (e.g. Diploma thesis). This page should include Title, Abstract, Short summary of the research, Name of Department and Name(s) of academic supervisor(s).
- Curriculum Vitae (Attachment II)
Please attach your CV.
I certify that the information provided on this application is, to the best of my knowledge, complete and accurate. I understand that any misrepresentation may be cause for being denied consideration. Applicationswithout the applicant’s signature will not be processed.
Signature Date
Last Name First Name
Applications must arrive by 30.04.2016by e-mail to:
Applicant’s preferred communication address (e-mail, Skype, telephone, or postal address):
CaSR Biomedicine Application Form - Page 1 of 9