C ENTRAL E UROPEAN U NIVERSITY
.Date of Submission:
mm/dd/yyyy
S S UM U MM ME ER R S S C CH HO OO OL L G G RA R AN NT T
A A PP P PL LI I CA C AT TI IO ON N F F O OR RM M F FO OR R 20 2 01 16 6- - 20 2 01 17 7
P
ERSONALI
NFORMATION (PLEASE TYPE)Last name First name Middle initial
Male Female
Date of birth (dd/mm/yyyy) Citizenship Sex
Department/Program:
PhD year of study:
Permanent address
Number & Street
City/State Zip/Post code Country
Telephone Fax Email
The length of the Summer School course.
Please give start and end dates: from to
mm/dd/yyyy mm/dd/yyyy
I
NFORMATION ABOUT THES
UMMERS
CHOOL Name and address of university or research institution the Summer School is taking place at:
Institution/Number &Street
City/State Zip/Post code Country
Name/title of the Summer School course taken:
Name
DECLARATION: I undertake to comply with the University’s regulations and policy in regards to research grants
Signature
____________________________________________ ______________________________________
Name of the supervisor Signature of the supervisor Check list (please tick in the box):
Statement of Purpose, including: Information about the Summer School (e.g. a leaflet)
- Benefits of attending the Summer School for your future research/
academic work
Acceptance letter from the Summer School
Information on Housing costs and fees
CEU Transcript (unofficial)
Letter from CEU Supervisor
OFFICE USE ONLY
AP RJ RS
OFFICE USE ONLY AP
RJ
RS
C ENTRAL E UROPEAN U NIVERSITY
.B B UD U DG GE ET T R R E EQ QU UE ES ST T
Have you applied to other sources of funding? Yes No
If Yes, please attach a list of the sources and the deadlines by which you expect to receive an answer.
Please include the exchange rate:
€1.00 =F INANCIAL I NFORMATION :
Provide exact figures (in EUR) for the following:
Housing costs
€Health Insurance Cost
(please inquire as to the actual cost - it may be included)
€
Visa Fees
€Round trip airfare/train
€Sub total: €
