<p> Linder Höhe 51147 Köln, Germany Telephone: +49 (0)2203 601-0 Internet: www.dlr.de Internet: www.daad.de</p><p>Application for a DLR - DAAD Fellowship </p><p>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</p><p> www.daad.de/dlr</p><p>Name</p><p>Nationality</p><p>Application for Fellowship No.</p><p>DLR Institute</p><p>DLR-DAAD-Research Fellowship Application Form Page 1 2</p><p>1. Personal Data</p><p>Surname Please use exactly the name as stated in your passport, underline main name</p><p>Academic title</p><p>First name(s)</p><p>Date of birth</p><p>Place of birth</p><p>Country of birth</p><p>Country of residence</p><p>Gender male female</p><p>Marital status married single</p><p>Number of children</p><p>Present occupation </p><p>Present employer</p><p>2. Contact </p><p>E-mail</p><p>Street</p><p>Post code, town</p><p>County/state </p><p>Country</p><p>Fax</p><p>Phone</p><p>3. Secondary school education</p><p>Duration and Location fro to in m</p><p>Type of final exam (certificate title)</p><p>Date of Award</p><p>DLR-DAAD-Research Fellowship Application Form Page 2 3</p><p>4. Higher Education and Academic Degrees</p><p>Academic Major Subject University/ Town Country Duration Result Date Degree (%, A-D) of result Bachelor</p><p>Master</p><p>Ph.D.</p><p>Other degree</p><p>Degrees expected to be completed within the following months Degree Title______Date__/__/____</p><p>5. Language Skills</p><p>Language Years of learning Very good Good Fair Poor English German</p><p>6. Previous visits abroad for study / research / work </p><p>Country Town Institution Goal From To</p><p>7. Practical / professional work experience</p><p>Country Town Institution Goal From To</p><p>8. Envisaged Academic / Professional Career</p><p>9. Social Engagement / Extracurricular Activities</p><p>10. Other Information / Remarks</p><p>DLR-DAAD-Research Fellowship Application Form Page 3 4</p><p>11. Name and address of person to be notified in case of emergency</p><p>E-mail</p><p>Street</p><p>Postcode</p><p>Town/Suburb</p><p>State/County/Province</p><p>Country</p><p>Phone/ FAX</p><p>The completed application form must be accompanied by the following documents (in English):</p><p> 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.</p><p>Applicants for a Fellowship Type C (Senior Scientists) only need to append a statement of the reasons for applying, a list of publications, a complete curriculum vitae and a recent photograph.</p><p>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. </p><p>Applicant‘s declaration:</p><p>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.</p><p>Place Date Signature</p><p>DLR-DAAD-Research Fellowship Application Form Page 4 5</p><p>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.</p><p>DLR-DAAD-Research Fellowship Application Form Page 5 6</p><p>Appendix: Reasons for applying for the fellowship (if necessary please copy and fill in separate forms for each of the alternative fellowships you name)</p><p>Name of the applicant </p><p>Nationality</p><p>Fellowship No. </p><p>Please formulate the personal and scientific reasons why you are applying for this specific fellowship: </p><p>DLR-DAAD-Research Fellowship Application Form Page 6</p>