TO

THE DEPUTY MINISTER OF EDUCATION AND SCIENCE

AND HEAD OF PROGRAMME OPERATOR

FOR BG09 PROGRAMME

EEA SCHOLARSHIPS FUND

A P P L I C A T I O N F O R M
MOBILITY PROJECTS IN HIGHER EDUCATION AND RESEARCH MEASURE
MOBILITY OF higher education, research and administrative staff COMPONENT
fourth Call for Proposals
Name, Surname, Family name:
Postal address: / City: / Postal code:
Str./Bld. №/distr. / block / entr. / floor / apt.
Phone (office): / Phone (home): / Mobile: / Fax:
Personal e-mail: / Office e-mail:
Name of the home institution / Applicant’s status / Academic/Research/
Administrative staff member
(please delete what is not applicable)
Professional/
Research field, in which the applicant works / Educational/ Scientific degree held by the applicant

DEAR DEPUTY MINISTER,

I would like to apply for a scholarship from the EEA Scholarships Fund under the EEA Financial Mechanism Programme, Mobility Projects in Higher Education measure, 4th Call for Proposals, with an individual mobility project entitled “………………………………………………….” at:

Host institution: / City: / Country:
Purpose of mobility:

The present mobility project is oriented in the field of:

(please complete the field)
…………………………………….

Orientation of the mobility project in a priority field for the BG09 programme related to supporting the Roma inclusion (please complete if relevant):

□ / Orientation of the individual mobility project in the field of training children and students with special education needs, inclusive education and educational integration of children and students with other ethno-cultural background and from disadvantaged groups in the mainstream educational system, including of Roma origin, human rights, intercultural education, pedagogical methods and approaches for retaining children and students at school, reduction of early school leaving (please mark with “x” if such orientation exists);
□ / Orientation of the individual mobility project in the field Economy and Social Sciences, with a specific focus on strengthening the economic and social cohesion through integration of minorities, including of Roma origin (please mark with “x” if such orientation exists);
□ / Orientation of the individual mobility project in the field of Medicine or Dental Medicine, with a specific focus on health of ethnical minority groups, in particular of Roma origin (please mark with “x” if such orientation exists);
□ / The individual mobility project is in the field of Agriculture and is aiming to contribute to meeting the objective for supporting economical and social cohesion and integration of minorities (please mark with “x” if such orientation exists);
□ / The individual mobility project is in other field (please specify the field), with aim to directly contribute to meeting the objective for supporting economical and social inclusion of citizens of Roma origin (please mark with “x” if such orientation exists)
Please justify the relevance of your mobility project to the respective priority field mentioned above and related to supporting the Roma inclusion. If not relevant please complete “N/A”
……………………..

During my stay in the host institution I will implement the following activities (detailed description of activities):

1.  / …………
2.  / ……………….
3.  / ……………….
(Please enter as many lines are needed)

Detailed and motivated description of the expected outcomes of the mobility for my professional development, the development of the institution that I’m representing, and the bilateral cooperation:

1.  / …………
2.  / ……………….
3.  / ……………….
(Please enter as many lines are needed)

Relevance of the research topics and the research contribution to the development of the European Research Area:

……………………..
(Please describe)

Other motivation:

……………………..
(Please describe)

To this end, the following supporting documents are enclosed:

1.  / EUROPASS CV / □
2.  / A copy of personal identity document / □
3.  / A Letter of Motivation (max. 1 page) / □
4.  / A copy of a labour contract / □
5.  / A Letter of Recommendation from the applicant’s home institution / □
6.  / A List of Research Publications (if relevant) / □
7.  / A Letter of Invitation (in English) from the institution, which organises the mobility or from the host institution in the EEA ETFA state / □
8.  / A declaration stating that the candidate has not received any funding from other EU programmes, the EU Structural funds, EEA EFTA or other academic and scientific exchange programmes for the purposes of the present mobility / □
9.  / A copy of foreign language certificate (English for Iceland and Norway; English or German for Liechtenstein); / □
10.  / A recent colourful photo (passport format) / □
11.  / Other documents (please specify) / □
Date: / Signature:
City: / (Name, Surname, Family name)

Please, fill-in electronically and print!

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