21th CIMO WINTER SCHOOL

“The World Inside and Around Us”

6 - 11 March 2017, Finland

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Application form

Please type or use block letters

1. Personal information

Family name(s) First name(s)

Gender Citizenship* female male Place of birth Date of birth**

Marital status

Contact information Street address

City Postal code

Country E-mail

Telephone Number of foreign passport (if any)

2. University education (see Required annexes 1)

Name and location of institution Degree(s) Date of Or estimated (BSc/MSc/PhD) completion of completion year of degree degree

Major subject (select one) Minor subjects (select one or two)

3. Present state of studies/research (see Required annexes 2)

CIMO 7/2016 Home institution Home department

Address E-mail, Telephone, Fax (through which the applicant can be reached during office hours)

Field of studies/research (subject area: e.g. Medicine, Physiology, …)

Tentative title of the Doctoral thesis (or Master’s thesis)

Main research methods

Scientific interests

4. Thesis supervisor (see Required annexes 3)

Name, Academic title Institution, Department

Institution address E-mail, Telephone, Fax

5. English language proficiency (Common European Framework of Reference for Languages, CEFR)***

6. International experience

7. Other merits (personal grants, prizes, medals, diplomas etc.)

8. Peer-reviewed publications in English language scientific journals (select up to 5 best papers) (see Required annexes 4)

9. Give the names of the Finnish scientists/research group leaders with whom you have had preliminary contact (see Required annexes 5)

CIMO 7/2016

10. When would you have the possibility to work/study in Finland and for how long?

11. Hobbies

Signature

Place and date Signature

Required annexes 1. Copies of latest degree certificates and scores certificates (supplements to the diploma) and their translations 2. Description of your current research work (1-2 pages) including introduction, aims of study, experimental design and current status 3. Letter of recommendation from a supervisor or a senior colleague who is well acquainted with your work 4. Complete list of publications in the peer-reviewed English language scientific journals (if any) 5. Evidence of contacting at least one scientist/research group leader from Finnish Universities and of their replies: Copy/copies of correspondence or a letter of intent from a potential Finnish host. 6. One recent photograph of the applicant

*The applicants must be citizens of Russia or Ukraine. **The applicants should not be older than 35 years of age. ***A good knowledge of English language is required since only English is used in the Winter School (see more on CEFR language level at http://www.examenglish.com/CEFR/cefr.htm). No official certificate is required.

The complete paper versions of the applications should reach CIMO by 17 October 2016 at the following address:

Centre for International Mobility CIMO/ 21th CIMO WINTER SCHOOL P.O. Box 343 (street address/express delivery: Hakaniemenranta 6) 00531 Helsinki Finland

CIMO 7/2016