<p>IPCC Secretariat C/O World Meteorological Organization 7bis Avenue de la Paix C.P. 2300 CH- 1211 Geneva 2, Switzerland APPLICATION FOR SCHOLARSHIP AWARD Phone : +41-22-730-8208/54/84 Fax : +41-22-730-8025/13 Email: [email protected]</p><p>Deadline for submission: Candidates must also provide: 15 February 2015  Research proposal  Copy of passport/ID (if available) To be submitted online via portal at:  Provisional budget  Photo http://www.ipcc.ch/apps/scholarship/applicant/  Admissions offer for PhD studies/ certificate of enrolment </p><p>A. Brief presentation </p><p>Application submitted by:</p><p>Family name First Name(s) Nationality/ies</p><p>...... ………………………………. </p><p> for an IPCC Scholarship in the field of: Underlying science of climate change Socio-economic modelling related to climate change Climate Change and water Climate change and the oceans</p><p>Duration of studies:</p><p>Start Date …………………………. End Date ………………………… </p><p>Name of Institution (University/Department, country): ...... Intended Supervisor: Title, Name:…………………………………………………………………………………………… Supervisor’s Email/Tel. ……………………………………………………………………………………………..</p><p>B. Personal information concerning the student</p><p>Permanent address: Telephone: E-mail: </p><p>Mailing address (if different from above): </p><p>Telephone: E-mail:</p><p>Date of birth Country and place of birth Sex day month year </p><p>...... Male Female Education</p><p>Years attended Name, place and country Degrees, diplomas: Date of educational establishments Indicate main subjects obtained from to</p><p>Secondary, technical, etc. </p><p>...... </p><p>...... </p><p>...... Post-secondary, university, or equivalent </p><p>...... </p><p>Other studies Mention any other studies undertaken, including training/refresher courses</p><p>Fellowships and scholarships Describe any scholarships or other grants or awards you have obtained for your past or present studies</p><p>Visits abroad List any significant visits abroad not mentioned above</p><p>Publications and research List any significant publications (including publisher and date of publication) and any major research projects undertaken </p><p>Languages Mother tongue: </p><p>Reading ability Oral Comprehension Speaking ability Writing ability Other languages Easily Not easily Easily Not easily Fluent Not fluent Easily Not easily</p><p>...... </p><p>...... </p><p>...... Any certificates of language knowledge should be attached to this application </p><p>References List three persons, not related to the candidate, who can provide information on his/her qualifications. These persons should normally be teachers or supervisors acquainted with the candidate’s previous academic work </p><p>Full Name Title and Address Previous professional activities (complete if applicable)</p><p>Employer Dates of service Responsibilities From To</p><p>Present position (complete if applicable)</p><p>Name and address of employer Current duties ...... Years of service From To </p><p>...... Exact title of post ...... Annual salary </p><p>...... Name and title of supervisor ...... C. Objectives Details of proposed studies for 2015-17 Give precise details of studies to be undertaken PhD studies in:</p><p>Title of research topic:</p><p>Taught courses or specific training to be undertaken, if any:</p><p>Approximate Itemized Budget Total expected budget …………………. (please provide breakdown on excel sheet provided)</p><p>Expected results </p><p>Candidate’s statement If IPCC grants me a scholarship, I agree to apply what I have learned for the benefit of my home country, assuming an appropriate assignment at my country’s government or other institution is offered. If I do not return to my home country for at least 3 years of service, I am prepared to refund the scholarship amount awarded. I certify the information I have provided is complete and accurate </p><p>______Date Candidate’s signature </p>