Linder Höhe 51147 Köln, GermanyTelephone: +49 (0)2203 601-0

Internet: www.daad.de

Application for a

DLR - DAAD Fellowship

Before completing the application form and attaching additional documents please read carefully the special guidelines and conditions of the “DLR – DAAD Fellowship Programme”

and the respective offer under

www.daad.de/dlr

Name

Nationality

Application for Fellowship No.

DLR Institute

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1. Personal Data

Surname

Please use exactly the name as stated in your passport, underline main name

Academic title

First name(s)

Date of birth

Place of birth

Country of birth

Country of residence

Gender male female

Marital status married single

Number of children

Present occupation

Present employer

2. Contact

E-mail

Street

Post code, town

County/state

Country

Fax

Phone

3. Secondary school education

Duration and Location from

to in

Type of final exam (certificate title)

Date of Award

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4. Higher Education and Academic Degrees

Academic Degree

Major Subject University/ Town Country Duration Result (%, A-D)

Dateof result

Bachelor

Master

Ph.D.

Other degree

Degrees expected to be completedwithin the following months Degree Title_______________________________ Date__/__/____

5. Language Skills

Language Years of learning Very good Good Fair PoorEnglishGerman

6. Previous visits abroad for study / research / work

Country Town Institution Goal From To

7. Practical / professional work experience

Country Town Institution Goal From To

8. Envisaged Academic / Professional Career

9. Social Engagement / Extracurricular Activities

10. Other Information / Remarks

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11. Name and address of person to be notified in case of emergency

E-mail

Street

Postcode

Town/Suburb

State/County/Province

Country

Phone/ FAX

The completed application form must be accompanied by the following documents (in English):

abstracts of the final dissertation or the doctoral/PhD thesis (max. 3 pages); statement of the reasons for applying for a certain fellowship (form see appendix); list of publications if any; complete curriculum vitae; two letters of reference from senior academics from the applicants field; officially authenticated copies of

all university final academic transcripts (with individual grades), university diploma or degree of certificate indicate the final grade(s);

English language certificate giving evidence of the applicants level of proficiency; recent photograph, attached to the application form.

The application and accompanying documents will remain with the DAAD. Personal data will be stored in the DAAD’s computer files only to the extent necessary for administration of applications and fellowships and in compliance with the “Federal Data Protections Act“. Data will be provided to the respective DLR Institute which will decide on the fellowship awardee. Applications of unsuccessful candidates will be destroyed after one year.

Applicant‘s declaration:

I certify that the information in this application is accurate to the best of my knowledge. Furthermore I agree to inform the DAAD immediately of changes and amendments.I have taken note of the information provided regarding this application as well as the notice about the storage of personal data. I accept responsibility for my completed application. I agree that this application and accompanying documents shall remain with the DAAD.

Place Date Signature

Applications may be submitted to the DAAD Regional Offices or directly to DAAD Head Office in Bonn, desk 522. The DAAD regrets to be unable to consider incomplete applications.

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Appendix: Reasons for applying for the fellowship (if necessary please copy and fill in separate forms for each of the alternative fellowships you name)

Name of the applicant

Nationality

Fellowship No.

Please formulate the personal and scientific reasons why you are applying for this specific fellowship:

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