PhD fellowships 2014-2017:
Application form
Personal data
Thesis topic:
Surname: First name:
Date of birth: Place of birth:
Nationality:
Email address: Phone number:
PhD Supervisor/Mentor
Surname: First Name:
Department/unit : Rank:
University: Phone number:
Email address:
To the supervisor:
If possible, what is your opinion on the quality and state of progress of the master thesis (if progress)?
Research proposal:
Host laboratory (PhD supervisor’s laboratory)
Title of the Research Laboratory: Address:
Head of the Research Laboratory:
Phone number: Email address:
Umbrella body(-ies) of the Research Unit:
To the Head of the Research Laboratory
How will the PhD student contribute to the Labex’s activities:Graduate Program
Title of the Graduate Program : Address:
Head of the Graduate Program :
Phone number: Email address:
Institutions involved in the Graduate Program :
To the Head of the Graduate Program
Opinion of the Graduate ProgramCo Supervision
Is your thesis co supervised? : Yes No
Title of the foreign university:
Address:
Name of the co-supervisor:
Email address: Phone number:
Date:
Signature of the Applicant Signature of the PhD Supervisor
Signature of the Head of the Host Laboratory Signature of the Head of the Graduate Program