Application form Wageningen Talent Programme 2016
1. Proposal title
2. Details of applicant
- Title:
- First name:
- Initials:
- Prefix:
- Surname:
- Male/female:
- Address for correspondence:
- Telephone:
- Email:
- Private email (optional):
- Website (optional):
3. Graduate School
Indicate the graduate school you will apply to. Each graduate school has one fellowship available, competition will take place between applicants within one graduate school.
EPS/PE&RC/VLAG/WASS/WIAS/WIMEK
4. Curriculum vitae applicant (max 3 pages, publication list excluded):
4a. Personal details
Title(s), initial(s), first names (in full), surname:
Nationality:
Date of Birth:
4b. Master's degree
University/College of Higher Education:
Faculty:
Date of the certificate:
Main subject:
4c. Doctorate
University/College of Higher Education:
Date and place that the doctoral degree was obtained as stated on your certificate:
Principle Supervisor:
Title of thesis:
4d. Current employment and work experience since graduation
4e. Brief summary of pre- and/or postdoctoral research experience
(max. 300 words)
4f. International activities (research and study) indicating the duration per activity
4g. Scholarships and prizes
4h. Other academic activities
4i. List of Publications
5. The Proposal
5a. Summary of the proposal (max. 250 words)
5b. Description of the proposed activities (4 pages maximum, including figures, excluding literature references)
Include details of objectives, innovative aspects, scientific approach, impact, institutional collaboration and literature references
5c. Value of the proposal to your career
5d. Value of the proposed collaboration for the affiliated Wageningen University research group and Wageningen University
5c. 5 most relevant publications of the collaborating partners related to the proposed activities
1.
2.
3.
4.
5.
6. Composition of the research group
List all staff members involved in the proposed activities: provide name, initials, titles and type of involvement, e.g. daily guidance, technician, thesis supervisor, advisor.
Name and title Specialisation Institution Involvement
7. Timetable of the activities
8. Scientific embedding of the proposed activities (max. 250 words)
Affiliation with national and international research programmes, national and international collaborations
10. Budget
Financial assistance from other sources:
Is the financial support and equipment sufficient to carry out the research?
11. Societal relevance
12. Legal requirements
Has been complied with the law and legal requirements with respect to the proposed activities, such as ‘DNA-recombinant legislation’, ‘Code Openness Animal Experiments’, and/or ‘Code of conduct on Biosecurity’ (if applicable)?
Ο Yes Ο No
By submitting this document I declare that I satisfy the nationally and internationally accepted standards for scientific conduct as stated in the Netherlands Code of Conduct for Scientific Practice 2012 (Association of Universities in the Netherlands (VSNU)).
Ο Yes Ο No
Details applicant:
Name:
Place:
Date:
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