EM Master s Programme in Information Technologies for Business Intelligence IT4BI. Scholar Application Form. Instructions

Transcription

1 Erasmus Mundus Master s Programme in Information Technologies for Business Intelligence - IT4BI - Instructions Please read the instructions carefully before filling in the application form. Only complete application forms will be processed. The application form and the mandatory documents should be sent by to: contact.it4bi@univ-tours.fr Ø Application Requirements: To apply for a visiting scholar scholarship, candidates must: have successfully completed a PhD or advanced research degree in a field related to the masters programme; be proficient in English, as it is the language of tuition; work currently in a higher education institution in any country (third-country applicants must not have lived in an EU/EEA-EFTA member state for more than 12 months over the past five years). Ø Documents to be attached An up-to-date Curriculum Vitae singleing out up to 5 articles and up to 5 research projects which are related to one of the courses of IT4BI; and if applicable the name and other details of up to five courses recently given in English; A copy of the PhD diploma; A letter of motivation and activity plan (please choose the preferred period of stay between minimum 2 weeks and maximum 3 months and specify the plan of your activities: teaching/research/student tutoring activities); A copy of a valid passport. Receiving Date: For office use only (please leave blank) Decision: - 1 -

2 1. Personal Data Title Mr. Mrs. Miss First Name Surname Date of Birth (dd/mm/yy) Place of Birth (city, country) Nationality 2. Contact Details Current Fields in bold are compulsory Permanent/Home (If different from above) Fields in bold are compulsory Street Name & No. City Postal Code State Country Telephone Mobile Phone Fax No. Alternative Valid until: Street Name & No. City Postal Code State Country Telephone Mobile Phone Fax No. Alternative

3 3. Current Position Employer Position Starting date 5. Previous Stay in Europe (only for third-country scholars) Country Position Date of Entry Date of Departure 6. Language Proficiency Mother Tongue English (Please indicate your level of proficiency and note that English will be the language of tuition) Other Languages French Spanish German Other (specify) Please specify your level of proficiency: - 3 -

4 7. Host Institution Please tick the appropriate box: For third-country scholars Université Libre de Bruxelles, Belgium Université François-Rabelais, France Ecole Centrale Paris, France Universitat Politècnica de Catalunya, Spain Technische Universität Berlin, Germany For European scholars Universidade Federal Uberlandia Brazil Université Gaston Berger de Saint-Louis Senegal Politechnika Poznanska Poland Université Libre de Bruxelles, Belgium Université François-Rabelais, France Ecole Centrale Paris, France Universitat Politècnica de Catalunya, Spain Technische Universität Berlin, Germany 8. Mobility Period Please indicate when you intend to perform your mobility period: Starting Date: Ending Date: 9. Proposed Activities and Statement of Motivation Please describe the activities you wish to undertake: Name of the course: Subject: Number of hours: Teaching Activities Research Activities Lab: Research area: Please explain why you wish to apply as a scholar: - 4 -

5 10. Special Needs Do you have special needs? Yes No If yes please specify the type of disability (learning, eyesight, hearing, mobility, cognitive, ), and indicate the type of support you may require: 12. Declaration and Signature I certify that all information given in this application is true and correct to the best of my knowledge, and I understand that any false information may disqualify my application. Date: Signature: - 5 -