Marshall Plan scholarship

APPLICATION FORM – UNI GRAZ students

Please complete the application form on the computer and send it in word-format and PDF-format to .

1)PERSONAL DETAILS

First name / Middle name
Last name
Sex / סmale סfemale / Date of birth (DD.MM.YYYY)
Nationality / Student ID nr (Matrikelnummer)
Home address
Zip code / city / state / country
Telephone nr
Cell phone nr
Email
Emergency contact

2)ACADEMIC DETAILS

Home university / Karl-Franzens-Universität Graz
Level & field of study at home university
Last degree completed / סnone סbachelor סmaster סother:
Currently enrolled as / סbachelor סmaster סPhD student
Current semester
Level of English knowledge /  none  A1  A2  B1  B2  C1  C2

3)BANK DETAILS - US BANK ACCOUNT

Account holder
Bank account nr / IBAN
Name of bank
Bank address
Routing nr / BLZ / BIC / SWIFT

4)RESEARCH DATA

Topic of research assignment
Planned research period at host university(min. = 3 full months excl. arrival and departure day):
From (DD.MM.YY) / To (DD.MM.YY)
Paper presentation deadline (max 3mo after mobility)
Retention period end date, see specific regulations below*
Name of supervisor at University of Graz
Email of supervisor
Name of professor providing recommendation 1
Email of referee 1
Name of professor providing recommendation 2
Email of referee 2

* Please note that in case you request a data retention period, the following rules apply

<3 yrs retention period request must be accompanied by a signed statement by the student as well as a signed statement by the home university supervisor on official university letter head stating the duration of the requested data retention period and the reasons why this is necessary.

>3 yrs retention period request must be accompanied by the same statements indicated above as well as by a 2.000 word summary (excl. Title page, content page and references) for immediate publication on the MPS website.

5)HOST UNIVERSITY SUPERVISOR

Name of Host University
Name of supervisor at host university
Dept. at host university
Address
Zip code / city / state
Email of supervisor
Telephone nr
Status at the host university during stay / סundergraduate סgraduate
סvisiting scholar סvisiting fellow
סother:

6)QUALIFICATIONS and EXPERIENCE

Provide information on your previous experience relevant to your research project. This may include previous studies, research or teaching experience as well as relevant experience outside the academic sector.

7)OBJECTIVES and MOTIVATION for the intended RESEARCH STAY (600-700 words)

Describe your personal motivation for applying to do research at University of Graz, why and how the intended research stay will enhance the overall outcome of your thesis as well as impact on your personal development.

DECLARATION

I hereby declare that I fulfil the eligibility criteria of the program as indicated in the call and that all information provided in this application is to my best knowledge, correct, and complete.

I acknowledge and agree (accord. To data protection act BGBl. Nr. 193/1978 i.d.g.F.) to the data included in this application are being passed on to the Marshall Plan Scholarship Foundation for the processing of the application as well as for statistical purposes and that any fotos of official Marshallplan Scholarship events can be used for promotion purposes by University of Graz and the Marshall Plan Scholarship Foundation.

I agree to my name and contact details being passed on to other students interested in Marshall Plan Scholarship:
 yes NO

I acknowledge and accept that an incomplete application or an application completed by hand will NOT be accepted and processed.

Date (DD.MM.YYYY) / Signature