Application for funding under the Caroline von Humboldt Programme

International Research Awards

Application deadline: 2 January 2015 (Earliest start of funding: 1 April 2015)

Surname

First name

Postal and e-mail address

Nationality

Do you have children? Yes* No If so, how many children do you have? _______ * If you are awarded funding, please send in a copy of your child’s or children’s birth certificate(s).

Are you enrolled as a PhD student at Humboldt-Universität? Yes No Student number __________________ Faculty _______________________________________

Academic qualifications

Examinations (incl. results)

Thesis/Research Project

Title: Academic field:

Host institution

Name of your external supervisor: Department/institute: University: City: Country:

Contact person at HU (only for doctoral students)

Name of your PhD supervisor: Institute: Faculty: Unit / department (where relevant):

Preferred funding period (Funding is provided for a maximum of nine months): _____ months, starting in (month / year) ___________ and ending in (month / year) _____________

We would be grateful if you could provide the following information for our statistics:

How did you hear about the grant?

Are you applying for similar grants or have you already done so? No Yes If yes, please specify:

Applications must contain the following:

o An application letter o A completed application form o A concept paper (max. 3,000 characters) that explain the usefulness of the research for your PhD/research

project o Certificates and academic CV o A letter of recommendation from your PhD supervisor or advisor

(The form for the letter of recommendation can be downloaded as a PDF file. Your supervisor/advisor should send this form directly to the e-mail address provided below.)

o A declaration by the host institution o A signed target agreement between you and your supervisor acc. to the guidelines of the doctoral program

culture of the HU is recommended (only for doctoral students) Please send your application with all the relevant documents by e-mail (as a PDF file) to frbfoerd@hu-berlin.de at the office of the Commission on the Advancement of Women, Office for Gender Equality. The subject line should read “International Research Award, summer semester 2015” and your name. (Please state only the type of grant for which you are applying.)

Geschäftsstelle der Kommission für Frauenförderung Büro der zentralen Frauenbeauftragten Caroline von Humboldt-Programm Unter den Linden 6 10099 Berlin

You will receive confirmation of receipt.

Statement of commitment In accepting a grant, I undertake to:

a) participate in surveys concerning the InRa (or others) of the Stabsstelle Qualitätsmanagement b) submit proof that I have handed in my thesis, at the latest two years after the funding ends (If I am unable

to produce this proof, I will provide a written explanation of the reasons for the delay.) I herewith consent to being contacted and surveyed by the Office for Gender Equality after the funding has ended for programme evaluation and quality assurance purposes.

Place / date

Signature