CBI Pro-Akademia

Dioscuri - application form

Dioscuri - application form

Personal data

Last Name*

Last Name at Birth

First Name(s)**

Gender*

Title

Country of residence*

Nationality*

Nationality 2*

Please leave 'none' if not applicable

Date of Birth*

Please enter date as DD-MM-YYYY

Town of Birth*

Contact address

Street*

Postcode/Cedex*

Town*

Phone*

Phone 2 / Mobile

Country*

e-mail*

Qualifications

Doctorate - Date of award

Please enter date as DD-MM-YYYY

h-index according to Scopus*

Attachments

CV*

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List of publications*

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Cover letter with a brief description of the proposed research topics of the planned Dioscuri Centre*

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Confirmation of interest in participation in NCN/MPG Call*