RESEARCH MOBILITY PROGRAMME (RMP) APPLICATION FORM PhD (Please word process and send a signed hard copy by e-mail to your local RMP Coordinator) Home University: Host University: Date commenced PhD How is PhD funded? First name: Last name: Mr/Mrs/Ms Telephone no: Email: Faculty/Department: Applicant’s address: Date of birth (required by some university systems): Proposed host institution: Host supervisor: Supervisor address: Telephone No: Email: Proposed project title: Proposed start date: Proposed end date: Please provide details of any research and academic links which already exist between your department / school and the department/school in the WUN partner institution. Details of funding to be applied for: Funding guidelines: (i) Travel expenses (economy airfare, internal travel costs to host institution, visa); (ii) Accomodation cost (for stay at host institution) Item Travel expenses Detail Total Accomodation cost Total claimed In no more than 1,000 words please provide information on the following in an attached, signed statement: (a) summary of the research you intend to undertake, detailing proposed interactions with the WUN partner institution (b) the anticipated benefits of the award, both for yourself and for the universities involved (c) any exceptional expertise or facilities available to you through this visit (d) how you and your department/school propose to sustain research relationships built through your visit We require a supporting statement from your home supervisor to be attached. This statement should explain benefits to you, your group, and department and should indicate how the research relationships built will be sustained after the visit. Name of home supervisor Email address We require a supporting statement from the host supervisor to be attached. This statement should confirm that you are welcome as visiting researcher/PhD under the WUN Research Mobility Programme and fee waiver is confirmed with the host university Name of host supervisor Email address Statement from Applicant. I wish to apply for a Worldwide Universities Network PhD RMP Award. If successful, I undertake to observe the Award Regulations and to provide a final report to the local University of Bergen WUN RMP Coordinator. I agree that the University and Worldwide Universities Network may hold and process personal information in connection with this RMP and may use my name and the information relating to this proposed research visit for any publicity purposes that they deem appropriate. Signed Date