5th Edition of the PhD Program - Application form

PERSONAL DETAILS OF THE APPLICANT

Title (Mr/Mrs/Ms/etc)

Family name / Surname

Given name / First name

Birth date

Country of birth

Nationality

Identification number

Marital status

Telephone number (mobile)

E-mail address (own)

Institution/Organization/Business where you work

Address

Address 2

City/Town

ZIP/Postal Code

Country

Current job title

EDUCATIONAL BACKGROUND

Degree obtained

Full name of institution and country where degree was obtained

Year obtained

PhD REGISTRATION INSTITUTION (where you are registered)

Name of institution where registered

Address of institution

City

Country

Supervisor(s)

E-mail address of supervisor(s)

Topic of PhD research

Year of first registration for PhD

Which software programme do you use for statistical analysis?

PUBLICATIONS

List your significant publications or research projects of the last 5 years

LANGUAGE ABILITY

First language

Other languages

Please rate your English language proficiency from 1 (poor) to 3 (acceptable) to 5 (very good)

Questions	1	2	3	4	5
Spoken	1	2	3	4	5
Understanding	1	2	3	4	5
Written	1	2	3	4	5

PROFESSIONAL ACTIVITIES

Describe your current responsibilities and professional activities

PERSONAL STATEMENT

Explain why you are applying for this PhD Support Program, what you hope to learn from it and how will it benefit your professional development.

APPLYING FOR A GRANT

Are you going to apply for funding (grant) from the organizers?

Please indicate the type of grant you want to apply for

Tuition fee

Accommodation

Write a motivation why you should receive the Tuition fee grant

Write a motivation why you should receive the Accommodation grant

NO travel grants are available: Availability of funds for travel must be confirmed when confirming that you will take up a position for the Program (you will receive a letter after the selection process indicating if your application was successful or not).

Upload files

Official Endorsement

Upload requirements

Two page concept note of your research

Upload requirements

Letter of support from your supervisor to participate in the PhD Support Program

Upload requirements

Passport

Upload requirements

University Registration Letter

Upload requirements

Supporting Nutrition Research and Education in Africa

5th Edition of the PhD Program - Application form