Plato’s Academy: Pathways to Knowledge

Project: «Plato’s Academy:- the development of Knowledge and innovative ideas»

Application Form for the Summer School of Philosophy and Applied Research

July 13-27, 2014

Please paste your photo in the box

SECTION A – PERSONAL DETAILS

Surname/Family Name: / First Name, Second Name:
Title (e.g. Dr/Mr/Ms): / Date of Birth: (DD-MM-YYYY)
Gender (Male/Female): / Nationality:
Contact Telephone No: / Contact e-mail
Permanent Home Address: / Correspondence Address (if different):

Language Ability

Language / Native Speaker / Excellent / Very Good / Good
1. English
2.
3.

SECTION B – ACADEMIC INFORMATION

B.1 Indicate details of all POST-SECONDARY education, academic and professional qualifications achieved/expected (please put official title of award) with the most recent first. In case of successful application the student will have to provide photocopies of the certificates / diplomas. In case that they are emitted in language other than English, French, Greek, Spanish, German, Italian, Portuguese, Czech, Bulgarian, Russian, Farsi, Dutch the student will have to provide an official translation to English.

University / Institution attended (with date) / Degree Qualification title / Main Subject / Classification or Grade / Date of Award

B.2 Name the courses with subject relative to Philosophy, Epistemology, Cognitive Science, Ethics that you have attended during your undergraduate and postgraduate studies.

Please give detailed description of the course and of its subject. (academic programme, academic year, paper written in the context of the course, mark obtained etc.)

Course / Description

B.3 Expectations from the programme

Please explain what are you expecting to gain from the programme and how do you believe that it will be useful for your personal academic and/or professional development. Use the text-box below and be sure that the text will not exceed the 300 words


SECTION C. ADDITIONAL INFORMATION

C1. Please add here, in a short text, any information you think that would support your application.

C2. Health Condition

Do you have any medical condition or special need? YES NO
If YES please check one or more boxes below:
Dyslexia/Dyspraxia AD (H) D / Deaf/Hearing Impairment / Mobility Issues
Aspergers/Autistic Spectrum / Long Standing Illness / Multiple Impairments
Blind/Visual Impairment / Mental Health / Not Listed Elsewhere

SECTION D – DECLARATION

I hereby confirm that the information I have provided on this form is true, complete and accurate and that no information material to this application has been omitted.
Signature: ………………………………………… …………….
Date: ………………………………………………….

SECTION E – REFERENCE / LETTER OF RECOMMENDATION (OPTIONAL)

Referee’s Name: / Position:
Contact e-mail: / Contact Telephone No:
How long have you known the applicant and in what capacity:
Please write below, your comments on the applicant’s suitability for admission to the programme “Plato’s Academy: a gateway for applied philosophy in sciences”
Signature:
Date:

The project is implemented within the framework of the Operational Programme “Education and Lifelong Learning” and it is co-sponsored by the European Union (European Social Fund) and National Sources.