CAS by jizhen1947


									                                           Mailing Address: 7-B, Stefan Karadja Str., Sofia 1000 Bulgaria;
                                           Tel.:+359 2 980-37-04; Fax:+359 2 980 36 62;
                                           Contact person: Neliya Kolarska, E-mail:
                                           Information about this programme can be found on:

                                     (1 March 2012 – 28 February 2013)

                                         APPLICATION FORM

1. Last name:

2. First name:
                                                                                        Provide a recent
3. Citizenship(s):                                                                           photo
4. Gender:                                                                            (can be separately
5. Date and place of birth:

6. Mailing address:

7. Tel, Fax (with country and local area codes):

8. E-mail:

9. Field of study:

10. Title of your project:

11. Preferred starting date of fellowship:

12. End date of fellowship:

13. Duration in months:

NOTE: The in-residence fellowships are extendable from 2 to 5 months within the following time frame: 1 MARCH
2012 – 31 JULY 2012; 1 OCTOBER 2012 – 28 FEBRUARY 2013. CAS reserves the right to further negotiate with the
candidates the timing of their fellowships in view of ensuring an optimal composition of the Fellows’ groups.

14. Present affiliations (institution(s), position(s) and dates):

15. Education (in reverse chronological order, including current, if applicable)

 Institution and location       Major field of study      Dates of          Name of degree or                Date
                                                          attendance        diploma (in original             received/
                                                          (month and        language and English             Expected
                                                          year)             translation)
                                                          From To

16. Title of Ph.D. thesis (original title and English translation):

17. Scholarships or fellowships held at present or in the past (include source or sponsor, where held, and

18. Academic honors or prizes (with titles and dates):

19. Teaching experience:

20. Research (completed and ongoing):

21. Professional societies or other organizations in which you now hold a membership or in which you have
been active in the past:

22. Please indicate if you are planning to apply or have applied for a fellowship, scholarship, or other
grant or loan from another organization, government or educational institution for the period 2012-2013:

23. Knowledge of languages (Rate yourself Excellent, Good or Fair. Include all languages in which you have
some competency):

 LANGUAGE                                    READING                  WRITING                  SPEAKING

24. Other professional information you might wish to add

25. List of publications (If necessary, give also English translations.)

26. Outline of your intended research under the Advanced Academia Programme (2000 – 2200 words). It
must be on a topic different from the topic of the PhD thesis, and must include:

    -   a short description of the planned research (state-of-the-art in the field, objectives and novelty of the
    -   methodology,
    -   selected bibliography (10-15 titles).

27. Recommended: a relevant text (chapter of a dissertation, publication, etc.) of up to 25 pages, preferably in
English (or in the original language of the publication+ translation in English) (can be separately attached).

28. For Junior scholars (up to 12 years after PhD defense) only: two recommendations by established
scholars send directly to CAS by post, fax or e-mail by the referees before the Call deadline. Extensions to this
period may be allowed in case of eligible career breaks which must be properly documented (maternity
leave, long-term illness leave, national service).

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