Erasmus Mundus Joint Doctorate Application Form

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1 Erasmus Mundus Joint Doctorate Application Form Application Deadline: All application material must be received by February 19, Early applications are encouraged. How to Apply to (EMJDs) Candidate must provide in electronic form the following documents in English language. For all documents whose originals are not in English language, we require a certified English translation. Scanned copies of the documents are accepted. Admitted students will be requested to present the originals (or certified copies) of all documents they have transmitted electronically at application time. Contents of the Application Form : - Curriculum Vitae of the Candidate - Copy of the master diploma - ANNEXE 1 dully filled and signed electronically. - Two letters of recommendation - This application Form dully signed electronically. 1 - Personal Information: Given Name: Surname: Gender : Nationality: Date of birth: Place and country of birth: Address: City:

2 Postcode: Country: Phone number: Other Information : you can upload a file in the electronic form on our website () 2- Education Record University : Address: Degree : Area of Degree: Expected Date of Graduation: If you have attended more than one institution please list the last three academic years : Year Institution Degree 2009/ / /2012 Please indicate the diploma obtained: Please indicate any honors or award received: You should send a copy of your diploma to the coordinator of the :

3 3 - Recommendations Please indicate the name of two professors who have agreed to write letters of recommendation. Name: Title: Name: Title: They should send their letters to the coordinator of the : 4 - Scientific exposure We would like to know more about you. Please describe your interested in any prior research experience you have participated.

4 Please describe your scientific interests. Please describe your career goals. 5 - IRAP Ph.D Program: your future research project Please indicate three possible thesis subject at the IRAP PhD consortium (see our Thesis Subject on the website: ) First Subject: Second Subject: Third Subject:

5 6- Data Protection and signature The candidate is informed and has agreed to the fact that if he/she is selected (proposed for a fellowship, put on the reseve list, or enrolled on a self paying basis) his data may be used for the purposes of evaluating the Erasmus Mundus Programme and will be made available to the Agency, the EM National Structures, the EU Delegations and the Erasmus Mundus Doctorale candidate and Alumni Association (EMA), acting as stakeholders of the programme. The personal data is collected and used in accordance with Directive 95/46/EC of the European Parlianment and of the Council of 24 October 1995 on "the protection of individuals with regard to the processing of personal data and on the free movement of such data". The candidate is informed and has agreed to the fact that his data will be also transfered to Non-EU partners of our consortium for the quality assessement of the applications. Done at on Signature of the Candidate :

6 ANNEXE 1 : LETTER OF THE SUPERVISOR OF THE MASTER THESIS ( Please fill this letter and send it to : ) TITLE OF THE MASTER S THESIS: INSTITUTION : NAME OF THE SUPERVISOR : QUALITY OF THE THESIS (Choose : Insufficient / Satisfactory / Good/ Very Good /Exceptionnal). Independence of the candidate and his/her attitude towards the project :. Capacity to work in team :. Scientific level of the work produced :. Skill and oral presentation : GENERAL COMMENT ON THE CANDIDATE: COMMENT ON THE SUITABILITY OF THE CANDIDATE TO PURSUE Ph.D. WORK: ANY OTHER REMARKS.

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