ee
BG09 PROGRAMME
„SCHOLARSHIPS FUND OF THE EUROPEAN
ECONOMIC AREA”
TO
THE DEPUTY MINISTER OF EDUCATION AND SCIENCE
AND HEAD OF PROGRAMME OPERATOR
FOR BG09 PROGRAMME
EEA SCHOLARSHIPS FUND
APPLICATION FORM
for participation in the competition under the BG09 programme “EEA Scholarships fund”
MOBILITY PROJECTS IN HIGHER EDUCATION MEASURE
MOBILITY OF STUDENTS COMPONENT
FOURTH CALL FOR PROPOSALS
Name, Surname, Family
name:
Postal address for
correspondence:
City:
Postal code:
Str./Bld. №/distr.
Phone (home):
block
Phone (office):
entr.
Mobile:
Personal e-mail:
Name of the
home institution
Office e-mail:
Applicant’s
status
Specialty, in
which the
applicant studies
Higher
education
programme
Professional/
research
field, in
which the
not applicant
studies
Bachelor/Master/Doctor
(please delete what is
relevant)
floor
apt.
Fax:
Student/Post-graduated
student/Doctoral Candidate
(please delete what is not relevant)
DEAR DEPUTY MINISTER,
I would like to apply for a scholarship from the EEA Scholarships Fund under the EEA Financial
Mechanism Programme, Mobility Projects in Higher Education measure, 4th Call for Proposals,
with an individual mobility project entitled “………………………………………………….” at:
Host
City:
Country:
institution:
Purpose of
mobility:
During my stay in the host institution I will study in (please specify the name of the education
progarmme):
Detailed and motivated description of the expected outcomes of the mobility for my
professional development:
1. …………
2. ……………….
(Please enter as many lines are needed)
Orientation of the mobility project in a priority field for the BG09 programme related to
supporting the Roma inclusion (please complete if relevant):
□
Orientation of the individual mobility project in the field of training children and students
with special education needs, inclusive education and educational integration of children
and students with other ethno-cultural background and from disadvantaged groups in the
mainstream educational system, including of Roma origin, education in human rights,
intercultural education, pedagogical methods and approaches for retaining children and
students at school, reduction of early school leaving (please mark with “x” if such
orientation exists);
□
Orientation of the individual mobility project in the field of Economy and Social Sciences,
with a specific focus on strengthening the economic and social cohesion through integration
of disadvantaged groups, including of Roma origin (please mark with “x” if such
orientation exists);
□
Orientation of the individual mobility project in the field of Medicine or Dental Medicine,
with a specific focus on health of ethnical minority groups, in particular of Roma origin
(please mark with “x” if such orientation exists);
□
The individual mobility project is in other field (please specify the field), with aim to
directly contribute to meeting the objective for supporting economical and social inclusion
of citizens of Roma origin (please mark with “x” if such orientation exists)
Please justify the relevance of your mobility project to the respective priority field
mentioned above and related to supporting the Roma inclusion. If not relevant please
complete “N/A”
……………………..
To this end, the following supporting documents are enclosed:
1.
EUROPASS CV
□
2.
A copy of personal identity document
□
3.
A Letter of Motivation (max. 1 page)
4.
Transcript of records for the last academic year (students only);
□
Admission Order in a doctoral programme (for doctoral candidates);
5.
A copy of foreign language certificate or diploma
□
6.
A Letter of Recommendation from the student/doctoral candidate’s home
□
institution
7.
A Letter of Confirmation (in English) from the host institution confirming the
□
admission of the student/doctoral candidate in the educational programme
8.
A document certifying that the training of the student/ doctoral candidate at the
□
home higher education/research institution is financed by a Roma supporting
programme or initiative (if applicable)
9.
A declaration stating that the candidate has not received any funding from other
□
EU programmes, the EU Structural funds, EEA EFTA or other academic and
scientific exchange programmes for the purposes of the present mobility
10. A recent colourful photo (passport format)
□
11. Other documents (please specify)
□
Date:
Signature:
City:
(Name, Surname, Family name)
Please, fill-in electronically and print!