genetime
a Marie Curie training site
http://www.york.ac.uk/depts/arch/GT
APPLICATION FORM:
SHORT TERM FELLOWSHIP
Application form
(please type in English)
Type here
____________________________________
Family Name
Type here
Type here
___________________________________
First name
_________________________________
Middle name(s)
________________________________________________________________________________
Street
_________________________________
Phone no. (home)
Type here
Type here
Type here
Type here
________________________________________________________________________________
Postal code, city
Type here
____________________________________
Country
Type here
____________________________________
Date of birth
Type here
___________________________________
Fax no.
Type here
___________________________________
Place of birth
_________________________________
Phone no. (work)
Type here
_________________________________
E-mail
Type here
_________________________________
Nationality
SCIENTIFIC FIELD AND RESEARCH GROUP PREFERENCE
After reading about the research activities of the various researchers in GeneTime please indicate the
research group(s) and projects in which you would like to work:
Your options are, Bradley, Dublin; Willerslev, Copenhagen; Shapiro, Oxford; Collins, York.
1.
2.
3
QUALIFICATION FOR GENETIME
The Marie Curie Early Stage Researchers supports those at the beginning of their
research careers with less than four years of seniority after their Master’s degree.
Eligibility conditions for Marie Curie fellowship are restricted according to citizenship and
geographic origin.
Applicants may check their eligibility by consulting the handbook of Marie Curie Program
at http://europa.eu.int/comm/research/fp6/mariecurie-actions/action/level_en.html.
I confirm that I am aware of the European Union regulations regarding eligibility for
a short term Marie Curie Fellowship First Degree (Bachelor Degree, or equivalent)
and that I am eligible for the award.
genetime - Application Form - page 2
EDUCATION
First Degree (Bachelor Degree, or equivalent)
________________________________________________________________________________
University/College
____________________________________
First Degree
___________________________________
Date (expected)
_________________________________________________________
Name of Advisor (if applicable)
_________________________________
Dates (from - to)
_________________________________
Grade (if known)
________________________________________________________
Subject area of study
Second Degree (Master’s Degree, or equivalent)
________________________________________________________________________________
University/College
____________________________________
First Degree
___________________________________
Date (expected)
_________________________________________________________
Name of Advisor (if applicable)
_________________________________
Dates (from - to)
_________________________________
Grade (if known)
________________________________________________________
Subject area of study
If you have already obtained your degree or certificate of marks, please include a photocopy of the
certificate.
If your education has been interrupted, or if you have already obtained other diplomas or equivalent, please
specify in the space below the occupation(s) you have pursued in the interim.
genetime - Application Form - page 3
Please give a brief summary in tabular form of your education and training at university, college, etc.
(i.e. after leaving school). Do not exceed this page.
genetime - Application Form - page 4
Coursework
Please list the courses you have taken and the grades obtained. Include all university level or other relevant
courses. If you have passed final University examinations, please give details. Do not exceed this page.
genetime - Application Form - page 5
Research experience including your current PhD project (if any)
On this page write the title and a description of your diploma (thesis) research, or equivalent. Indicate the
significance, the aims and your contributions and, in all cases, state the number of months of research
involved. If you have carried out other research prior to your diploma, or since then, please describe it briefly
in a separate paragraph. Please do not exceed one page. List publications, if there are any.
genetime - Application Form - page 6
Scientific Interests
On this page, please write a short summary of the area of the GeneTime Program that you find most
interesting, and how a GeneTime short term fellowship will support your current studies. Do not exceed two
pages.
genetime - Application Form - page 7
genetime - Application Form - page 8
Honors, Scholarships, Prizes and Awards
In the space provided below, list any honors or awards that you feel are relevant to this application. Include
dates and a short description.
Personal interests
Please list below your personal interests that are not directly related to your university degree.
How did you learn about the program?
[ ] Internet web site
[ ] Advertisement in Scientific Journals, please specify here..
[ ] Friends, colleagues, other students, faculty members
[ ] Other, please specify here..
genetime - Application Form - page 9
REFERENCES
Please list below the names, institutions and institutional e-mail addresses of the two or
three referees who have agreed to write a letter of recommendation on your behalf. If you
are currently registered for a PhD or Masters program at least one of these must be your
current academic supervisor.
referee no 1
Name:
Institution:
Email:
referee no 2
Name:
Institution:
Email:
referee no 3
Name:
Institution:
Email: