1Applicants Personal Data

1 (2)

Global Bridges to Advance Health Care Research Careers for Junior Researchers 2015 - the first step - dnr UTB 3 – 2205/2014

1Applicants’ personal data

Applicant 1

Last name: / First name: / Pers id number:
E-mail: / University: / Phone number:
Department: / Adress:
Undergraduate degree: / Year: / PhD degree – name the subject: / Year:

Applicant 2

Last name: / First name: / Pers id number:
E-mail: / University: / Phone number:
Department: / Adress:
Undergraduate degree: / Year: / PhD degree – name the subject: / Year:

Applicant 3

Last name: / First name: / Pers id number:
E-mail: / University: / Phone number:
Department: / Adress:
Undergraduate degree: / Year: / PhD degree – name the subject: / Year:

2 Core-areas

Applicant 1

Point out the core-area your application relate to:
Health Care Research related to Women and Child Health
Health Care Research related to People living with long-term Disability
Health Care Research related to Older Adults living with Activity limitation and Participation restrictions
Health Care Research related to Cancer nursing and Palliative care
HälsoHealth Care Research related to Health systems, Policy, Management, Informatics and Economics.

Applicant 2

Applicant 3

3Presentation of the international scholar

Last name: / First name: / Pers id number:
E-mail: / University: / Phone number:
Department: / Adress:
Undergraduate degree: / Year: / PhD degree – name the subject: / Year:
Associate professor – name the subject: / Year: / Professor – name the subject: / Year:
Current employment:

4 Signatures of the applicants

Applicant 1

Date:Place:Signature of the applicant:

Applicant 2

Date:Place:Signature of the applicant:

Applicant 3

Date:Place:Signature of the applicant: