REQUEST TO THE RECTOR Application for post-doc fellowship Family

							                          REQUEST TO THE RECTOR
                      Application for post-doc fellowship

Family name (surname/last name):……………………………………………………..
First name (given name):…………………………………………………………...…...
Date of birth (day/month/year):…………………………………………………………
Place and country of birth:……………………………………………………………...
Gender: male/female
Nationality:……………………………………………………………………………...
Highest obtained university degree +place+date:………………………………………
………………………………………………………………………………………….
Marital status: …………………………………………………………………………..
Name Partner:…………………………………………………………………………...
Nationality Partner: …………………………………………………………………….

Full Postal address (Will be used to send official papers, no P.O.Boxes):……………..
………………………………………………………………………………………….
………………………………………………………………………………………….
………………………………………………………………………………………….
Telephone:………………………………………………………………………………
Faxnumber:……………………………………………………………………………..

Email:

I hereby request the VUB to invite me as a post-doctoral researcher
Description of the research:
……………………………………………………………………………….…………
…………………………………………………………………………………………
…………………………………………………………………………………………
…………………………………………………………………………………………
Estimated duration:…………………………………………………………………….
Desired subsidy (monthly amount in Euro):…………………………………………..
Prefered research promotor:……………………………………………………………
Faculty:…………………………………………………………………………………
Department:…………………………………………………………………………….

Place:……………………………………………………………………………………
Date:…/…/……
Signature:

Documents to enclose:
Résumé with list of publications.
Certified true copy of your diploma (highest academic degree). If the diploma is not in English, French
or Dutch please add an official translation (by a sworn translator)
Curriculum Vitae
Important notes:
The approval/acceptance of the subsidy does not create an employer/employee relation between the
VUB and the subsidized guest researcher.