School of Slavonic and East European Studies Application Form: The SSEES Foundation Scholarship Name: _________________________________________________________________________ Title of Proposed Thesis:____________________________________________________________ ___________________________________________________________________ Prospective Supervisor: _____________________________________________________________ Programme Application Status Application Date:______________________________ Application No. __________________________ Decision (if received): _______________________________________ Citizenship:_______________________________ Country of Residence:________________________ E-mail Address: ____________________________________________________________________ Correspondence Address:____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Please give a summary of your academic background (starting with highest qualification sought or achieved, including Institution’s name, subject of degree, degree classification, and attendance dates): __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Please list any awards, honours, or fellowships you have received (starting with the most recent, including dates and amounts of any fellowship). __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Please list any scholarly publications or invited scholarly papers (conferences or university seminar series). __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ Please include the following documents: 1. Personal Statement of up to 1,500 words Please describe your proposed research project, indicating how it will contribute to the existing scholarship in your field. You may want to highlight relevant academic achievements not listed above. 2. Two academic references These must be submitted together with this application form. Each must be submitted in a sealed envelope that has been signed across the seal. The information that I have given on this form is, to the best of my knowledge, accurate and complete. Signature_______________________________________________________ Date___________________________________________________________