REGISTRATION FORM
Julia Polak European Doctoral Award
Student name:
University and Department:
Address:
Supervisor(s):
Address(es):
Date of starting PhD work:
Date of registration for PhD (if not date of starting PhD work):
Courses attended:
PhD title (working/actual) delete as appropriate:
International Laboratory visit(s):
Laboratory(ies) visited/to be visited:
Dates of visit(s) (actual or proposed):
Language(s) used/to be used:
Signatures:
The candidate
Date:
The supervisor
SUBMISSION FORM
Julia Polak European Doctoral Award
Student name:
University and Department:
Address:
Supervisor(s):
Address(es):
Date of starting PhD:
Date of Registration for PhD (if not date of starting PhD work):
Thesis Defense/Viva Voce Examination:
Date:
Opponent/External Examiner/Jury (including their Affiliations):
Reviewers of thesis (including their Affiliations):
Conference presentations (please give full reference, including names of co-authors and attach
abstracts):
Papers produced from thesis (please attach full papers or url plus a letter from your Supervisor stating
your contribution to the papers):
Signatures:
The candidate
Date:
The supervisor
INSTRUCTIONS
Julia Polak European Doctoral Award
The registration form should be completed when you register for the Julia Polak European Doctoral
Award (EDA). Please include sufficient details to allow the Education Committee to review your
application.
The submission form should be completed once you have completed your PhD and within 2 years of your
Defense/Viva Voce Examination. This submission form should be submitted with all accompanying
documentation, preferably by email.
All addresses requested concern institutional contact details, where applicable, including email.
Candidates who are applying for the Julia Polak European Doctoral Award (EDA) after completing their
Ph.D. should complete both forms and submit them simultaneously.
Application forms should be sent to the chairman of the Education Committee:
Prof. Dr. Dirk W. Grijpma
Department of Biomaterials Science and Technology
University of Twente
PO Box 217,
7500 AE Enschede
The Netherlands
Email: d.w.grijpma@utwente.nl