DAVID-HERZOG-FONDS
Karl-Franzens-Universität Graz
Heirichstraße 22/3
A-8010 Graz
Application for a Scholarship
Personal details:
Family name: ......
First name: ......
Degrees/diplomas already obtained: ...... male female
Place and date of birth: ...... Citizenship: ......
e-mail: ......
Address 1:......
(current address)
......
(phone, fax)
Address 2: ......
(alternative address)
......
(phone, fax)
You would like to be informed about the decision under address 1 address 2
Is your medical insurance valid during a stay in Austria? Yes No
Details of planned study / research programme:
Length of stay: from (ddmmyy) ...... to (ddmmyy) ......
Target institution: ......
Target country: ......
Academic contact at target institution: ......
......
Planned study / research programme (exact details requested): ......
......
......
......
Reason of stay study programme diploma thesis dissertation research:
......
......
......
Letter of recommendation by:
1......
2......
School education:
Name and place of high school: / School-leaving exam in (year):...... / ......
University education:
Name and country of the university / field(s) of study / from - to...... / ...... / ......
...... / ...... / ......
...... / ...... / ......
Professional activities (also during study):
......
......
Career aspirations (not only name of degree):
......
......
Academic stay abroad longer than 3 weeks:
from - totarget countrytarget institutionreason of stay
......
......
......
Language knowledge:
German / English / Ivrit / ...... / ......excellent / / / / /
good / / / / /
basic knowledge / / / / /
It’s left up to the committee of the DHF to check the correctness of your details regarding the language knowledge. The final providing of a grant could depend on the presentation of a language certificate or - should the need arise - on the result of an exam.
Financial plan for ...... month(s)
The financial plan is to be filled out for the whole length of stay!
Current income (in EURO):Expected costs (in EURO):Available resources (in EURO):
Tuition fees / One’s own resourcesCost of living / Grant by own university
Travelling expenses / Grant of other institutions
Other costs / Grant of...... …….
applied
approved
Total costs / Grant of...... …….
applied
approved
The amount of the applied grant results from the difference between „Total costs“ and „Total of available resources“. / Total
"Available resources"
Total costs / EURO .-
Total
"Available resources" (minus) / EURO .-
Applied Grant /
EURO .-
Should the situation arise – Explanation for lack of resources
If you are not (or hardly) in charge of available own resources for your study abroad, please give short reasons for that.
......
......
......
......
......
......
......
......
......
Check-list
ent-spricht / fehlt / Kommentar der EinreichstelleApplication form completely filled out; photo attached
Applicant’s signature
Exact length of stay
Curriculum vitae in tabular form; signed
Detailed description of study / research plan
Academic contact at target institution
Transcript of records (confirmed by your university; copies of
certificates and diploma, authenticated and translated into German or
English; explanation of system of marks)
2 Letters of recommendation by professors.
possibly explanation for lack of own resources
Details concerning grants of other institutions
Costs estimate for travelling expenses by a travel agency
I am aware of the fact
- that I must not have any chronic or contagious diseases and must be of good health when entering the study programme and that I have to show a health certificate on demand.
- that the knowledge of the required national language is not an indispensable requirement for getting a David-Herzog-Grant; but if it is necessary to achieve the aim of my study plans, I have to be in charge of the knowledge. It’s left up to the DHF to demand a state-approved certificate on your language knowledge.
- that in case of not achieving the necessary results concerning my study / research plans I have to pay back the whole grant or parts of it to the DHF.
In case of granting a scholarship by the DHF I agree
- to inform the rector of the host university / leadership of the research institution on my study and research plans and to stay at the target institution.
- to send a detailed report to the committee of the DHF about my stay and my studies as well as a confirmation about the length of stay at the host institution (at the latest 1 month after expiry of the grant).
......
(place, date)(applicant’s signature)