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Formulaire de demande de bourse de thèse

VIEWS: 3 PAGES: 2

									                                 AIRD-Cirad
                        « Doctorants du Sud » Program
Have you ever submitted another proposal to one of the DSF calls ?                   No           Yes
If so, which programme was it ?
Your email address


Candidate
■■       Your information
- Please select - Surname (passport)
                  First name (passport)
Date of birth      /    /
Birth place
Nationality                                      Country of residence

■■       Master degree or equivalent (allowing PhD application)
Type of diploma - Please select -                               Issued on : (yyyy)
Field of study     - Please select -
Exact title
Institution which delivered the diploma

■■       Work details*
Status      - Please select -
Position - Please select -
Employer
Name of the unit/team
Date of recruitment         /         /     Date of appointment in current position       /   /

■■       Contact information for application process
Email address
Phone number                                     Fax number
Mail address          personal                 professional
Street number and name
Details
PO Box                                           Zip code
Town                                             Country

■■       Permanent contact information (if different from above)
Email address
Phone number                                     Fax number
Mail address          personal                   professional
Street number and name
Details
PO Box                                           Zip code
Town                                             Country

Doctorants du Sud – 2011 application form                                                           1
■■       Schedule
                                                            Nb
  Hosting team           Country             Town                             From                     To
                                                           months

                                                                               /     /                   /   /
                                                                               /     /                   /   /
                                                                               /     /                   /   /
                                                                               /     /                   /   /
                                                                               /     /                   /   /
                                                                               /     /                   /   /
                                                                               /     /                   /   /


Methodology proposed for the PhD topic
Title
First year of registration (yyyy/yyyy)    /
Academic field of study - Please select -
Keywords




■■       Methodology proposed for the PhD running (3 pages maximum)




*Please note this grant can not be combined with another allowance. Students with a permanent position are requested
to join to this application a certificate from their employer, mentioning they will not get a salary during the DSF
support.

Doctorants du Sud – 2011 application form                                                                        2

								
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