BUILDING ANTHROPOLOGY IN CEE /
1. General information
Current family name / / Gender / F / M
First name / /
Birth family name
/Date of birth /
Nationality / / 2nd nationality
Country of residence / / From (MM/YYYY)
2. Multi-Partner Training Site – Country and University in which the candidate would like to undertake his/her Marie Curie training
FIRST CHOICE /
Country / / University
Period of fellowship / Duration (months) / Planned start date (DD/MM/YYYY)
Supervisor request /
SECOND CHOICE
Country / / University
Period of fellowship / Duration (months) / Planned start date (DD/MM/YYYY)
Supervisor request
3. Brief description of the research training project to be undertaken by the candidate (3 lines)
APPLICATIONS THAT EXCEED THE WORD LIMIT WILL NOT BE READ
4. Current research
Are you currently registered and following a PhD course?
/ Yes / NoIf you are currently registered and following a PhD course, please fill in points 5 and 6 and then go to point 8.
If you are actively engaged in research without being registered for a doctorate, please fill in points 7 and following.
5. Abstract of PhD project (10 lines)
APPLICATIONS THAT EXCEED THE WORD LIMIT WILL NOT BE READ
6. Current research – Institution where candidate is registered and following a PhD course
Institution name /
Town/City
Country name /
Start date of doctorate (MM/YYYY) / /
Date or expected date of award of doctorate (MM/YYYY)
/Subject area of PhD
/Title of PhD thesis
/Grants or other forms of financing
/Full time
/ /Part time
/Interruption of PhD
/Start date (DD/MM/YYY)
/ /End date (DD/MM/YYY)
//
Reason
/7. Current research – Institution where candidate is actively engaged in non PhD research
Institution name /
Town/City
Country name /
Start date of research (MM/YYYY) / /
End date of research (MM/YYYY)
/Subject area of research project
/Title of research project
/Type of contract or other forms of financing
/Full time
/ /Part time
/8. Research experience
Please indicate the number of years/months of research activity since gaining a university degree giving access to doctoral studies in the country in which it was obtained. If on the date of recruitment (i.e. the first day of your studies at the recruiting institution)you have more than four yearsfull timeequivalent ofresearch behind you (either in employment or as part of your doctoral work) you are not eligible for Marie Curie Funding.
Research project 1
Full time / Part time
Start date (MM/YYYY) / End date (MM/YYYY)
Research project 2
Full time / Part time
Start date (MM/YYYY) / End date (MM/YYYY)
Research project 3
Full time / Part time
Start date (MM/YYYY) / End date (MM/YYYY)
9. Education – Institution where candidate acquired degree giving access to doctoral studies
Title (e.g. MA, MSc, BA) /
Institution name
/Town/City
/Country
/Date of award (MM/YYYY)
Title and subject area of degree
/10. Languages
Mother Tongue
/ /Reading skills
/Speaking skills
/Writing skills
Language
/ / / /Language
/ / / /Language
/ / / /Diplomas or certificates
Language (certificate)
/ /Date (MM/YYYY)
/Language (certificate)
/ /Date (MM/YYYY)
/Language (certificate)
/ /Date (MM/YYYY)
/11. Place of normal activity
Have you resided or been active for more than 12 months in the last 3 years in the host country? /
Yes
/ /No
/Specify the place(s) of normal activity during the previous five years (EXCLUDING short stays in another country, such as holidays) / Town/City / Country / Date
From (DD/MM/YYYY) / To (DD/MM/YYYY)
12. Contact address
Name
PO Box (if applicable)
Street Name and Number
Post Code / Cedex (if applicable)
Town/City
Country name
Telephone No / Fax No
13. Contact address of candidate’s academic supervisor or director of research
Title (Dr, Prof, …) / Gender / F / M
Name
Name of institution
Address
Telephone No / Fax No
14. Criminal convictions / Do you have a criminal conviction? YES NO
Please tick the YES or NO box to indicate your situation. Applicants with criminal convictions should be aware of the provisions of the Rehabilitation of Offenders Act 1974 as they affect those with spent sentences. Advice about whether you need to declare a conviction can be obtained from a solicitor, the National Association for the Care and Resettlement of Offenders, the Probation Service or the Citizens Advice Bureau. Should you need to declare a conviction, please enclose written details in a sealed envelope and return this with your application, this is done to ensure confidentiality.
15. An outline of the PhD or research project including reasons for applying for the fellowship and the nature of the training you are seeking (outline should not exceed 800 words)
APPLICATIONS THAT EXCEED THE WORD LIMIT WILL NOT BE READ
16. Declaration by the candidate
I hereby declare that the information in this form is correct.
DATE OF SIGNATURE
SIGNATURE OF CANDIDATE
17. How did you hear about the programme for which you are applying?
Tick the appropriate box
University Dept Education Fair/Exhibition Careers Office British Council
Internet/Web site Personal Recommendation EU portal National Course directory
Advertisement on mailing list Other (please specify)
If you have contacted a SocAnth member of staff, please give name:
18. Disabilities
SocAnth Partner Institutions welcome students with disabilities and will try to meet your needs wherever it can. Please check the relevant box.
0 None
1 You have dyslexia
2 You are blind or partially sighted
3 You are deaf or hard of hearing
4 You use a wheelchair or have mobility difficulties / 5 You need personal care or assistance
6 You have mental health difficulties
7 You have a disability that cannot be seen, for example,
diabetes, epilepsy or a heart condition
8 You have a disability, special need or medical condition that
is not listed above. If so please detail:
If you will need special facilities or support please detail:
PLEASE SUBMIT THIS FORM ONLINE AT http://ucl.ac.uk/mariecuriesocanth/online_application.php (SEE THE APPLICATION SECTION OF MARIE CURIE SOCANTH WEB SITE) AND SUBMIT A SIGNED VERSION INCLUDING THE FOLLOWING PAGE TO THE ADRESS IN THE BOX BELOW
Submitted by: ______Date:
(Student’s Signature)
Recommended by: ______Date:
(Advisor’s Signature)
Recommended by: ______Date:
(Department Head’s Signature)
This application is to be signed by all parties. A complete POSTAL application package also includes the following:
§ Current official university transcript
§ The Disabilities and Equal Opportunities Monitoring Form
Please submit your completed application online at http://ucl.ac.uk/mariecuriesocanth/online_application.php and by mail to the Marie Curie SocAnth office:
Marie Curie SocAnth Office
c/o Michael Stewart
Department of Anthropology
University College London
Gower Street,
London, WC1E 6BT
Email:
DEADLINE: 30th January, 2009
DISABILITY AND ETHNIC ORIGIN MONITORING FORM
Please note that this form will not be passed to any admissions tutor.
SOCANTH is required to supply this information to the UK Higher Education Statistics Agency as well as in EU reporting.
If you have a disability that may require adjustments to be put in place, you must contact the Disability Co-ordinator, of the Partner Institution/s to which you wish to apply.
Please consult the web sites of each institution to find the contact details.
SURNAME FIRST NAMES
DISABILITY Please (√) one box
Are you currently or have you previously been in receipt of a disabled student’s allowance in an EU or other state? Please (√) one box
ETHNICITY Please (√) one box
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