Visiting Programmes Application Form 2015 Application Deadline: 1 October 2015 Please complete this form and return it to the email address below. If you need assistance with completing the form, please do not hesitate to contact us. Email : visiting@graduateinstitute.ch Tel : +41 22 908 43 84 All fields marked with an asterisk (*) must be completed. PERSONAL DETAILS Family name (*) Date of birth (*) First name (*) Day Month Year Gender (*) Male Female Citizenship (*) ADDRESS Correspondence Address Street (*) Telephone number Postal Number (*) Email (*) City (*) Country (*) The Graduate Institute of International and Development Studies - http://graduateinstitute.ch/visiting P.O. Box 136, 1211 Geneva 21 | Tel. +41 22 908 43 84 | Fax. +41 22 908 57 10 1/4 ACADEMIC DETAILS Your Home University or Home Institution (*) Position (*) Year of PhD completion (if applicable) Dates you are planning your research stay at the Institute (*) (min. 2 month, max. 12 month) * If admitted, these dates cannot be modified Research project at the Institute (*) PROGRAMME Please specify the status you are applying for : See details, conditions and benefits of both status on http://graduateinstitute.ch/visiting : Senior Fellows in Residence (senior staff members of international institutions) Visiting Fellow (professors, lecturers and researchers, post-docs) Junior Visiting Fellow (doctoral students) AFFILIATION AT THE INSTITUTE Please specify the department or center you wish to join: your application file will be submitted to their Faculy members committee. There is no need to contact any Faculty member directly. See details of our departments on : http://graduateinstitute.ch/home/study/academicdepartments.html See details of our research centers on: http://graduateinstitute.ch/home/research/centresandprogrammes.html Departments or Research Centers* (1 choice only) Anthropology and Sociology of Development International Economics International History International Law International Relations and Political Science Centre for Trade and Economic Integration Centre for International Environmental Studies Centre on Conflict, Development and Peacebuilding Centre on Finance and Development Global Migration Center Global Health Programme Programme for the Study of International Governance Programme on Gender and Global Change Academic contact person (optional) : The Graduate Institute of International and Development Studies - http://graduateinstitute.ch/visiting P.O. Box 136, 1211 Geneva 21 | Tel. +41 22 908 43 84 | Fax. +41 22 908 57 10 2/4 REFEREES Please give details of two referees whom we may contact in case we need some additional information concerning your application and student/work status. These can be academic and/or professional references. First referee Name (*) Institution (*) Position (*) Relationship with you (*) E-mail (*) Telephone Second referee Name (*) Institution (*) Position (*) Relationship with you (*) E-mail (*) Telephone FUNDING SOURCES Have you applied for funding to undertake your research stay at the Institute ? Yes* No *If yes, please indicate which funding sources you have applied to (institution, country): ADDITIONAL INFORMATION If you stay longer than 2 months at the Institute, you are entitled to receive an email address firstname.name@graduateinstitute.ch. Please indicate your choice: I would like to receive an email firstname.name@graduateinstitute.ch I will not need an email address from the Institute The Graduate Institute of International and Development Studies - http://graduateinstitute.ch/visiting P.O. Box 136, 1211 Geneva 21 | Tel. +41 22 908 43 84 | Fax. +41 22 908 57 10 3/4 Applications should include : A curriculum vitae and a list of publications A letter of motivation stating the reasons for the application, the preferred semester, the Institute's discipline or area of expertise in which the candidate is interested A letter of support from candidate’s home institution or supervisor A brief work plan detailing the proposed activities to be completed during the candidate’s time at the Institute (update of teaching curriculum, research project, etc.) A copy of your passport. Please send back this completed form along with your documents in .pdf format by email to: visiting@graduateinstitute.ch before 1 October 2015. Only complete applications will be considered. THANK YOU FOR YOUR APPLICATION! For questions regarding the application procedures or any other aspect of the Visiting Programmes, please visit our website http://graduateinstitute.ch/visiting or contact us by email visiting@graduateinstitute.ch or by phone, Tel: +41 (0) 22 908 43 84 The Graduate Institute of International and Development Studies - http://graduateinstitute.ch/visiting P.O. Box 136, 1211 Geneva 21 | Tel. +41 22 908 43 84 | Fax. +41 22 908 57 10 4/4