Mailing Address: 7-B, Stefan Karadja Str., Sofia 1000 Bulgaria; Tel.:+359 2 980-37-04; Fax:+359 2 980 36 62; Webpage www.cas.bg; Contact person: Neliya Kolarska, E-mail: email@example.com Information about this programme can be found on: www.cas.bg ADVANCED ACADEMIA FELLOWSHIP PROGRAMME (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 attached) 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): 2 17. Scholarships or fellowships held at present or in the past (include source or sponsor, where held, and duration): 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 project), - 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).